Department of Gastrointestinal Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003, China.
Department of Immunotherapy, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003, China.
Cancer Biol Med. 2023 Dec 23;21(1):65-82. doi: 10.20892/j.issn.2095-3941.2023.0376.
Intestinal flora affects the maturation of the host immune system, serves as a biomarker and efficacy predictor in the immunotherapy of several cancers, and has an important role in the development of colorectal cancer (CRC). Anti-PD-1/PD-L1 antibodies have shown satisfactory results in MSI-H/dMMR CRC but performed poorly in patients with MSS/pMMR CRC. In recent years an increasing number of studies have shown that intestinal flora has an important impact on anti-PD-1/PD-L1 antibody efficacy in CRC patients. Preclinical and clinical evidence have suggested that anti-PD-1/PD-L1 antibody efficacy can be improved by altering the composition of the intestinal flora in CRC. Herein, we summarize the studies related to the influence of intestinal flora on anti-PD-1/PD-L1 antibody efficacy in CRC and discuss the potential underlying mechanism(s). We have focused on the impact of the intestinal flora on the efficacy and safety of anti-PD-1/PD-L1 antibodies in CRC and how to better utilize the intestinal flora as an adjuvant to improve the efficacy of anti-PD-1/PD-L1 antibodies. In addition, we have provided a basis for the potential of the intestinal flora as a new treatment modality and indicator for determining patient prognosis.
肠道菌群影响宿主免疫系统的成熟，作为几种癌症免疫治疗的生物标志物和疗效预测指标，在结直肠癌（CRC）的发生发展中具有重要作用。抗 PD-1/PD-L1 抗体在 MSI-H/dMMR CRC 中显示出满意的效果，但在 MSS/pMMR CRC 患者中效果不佳。近年来，越来越多的研究表明，肠道菌群对 CRC 患者抗 PD-1/PD-L1 抗体疗效有重要影响。临床前和临床证据表明，通过改变 CRC 患者肠道菌群的组成，可以提高抗 PD-1/PD-L1 抗体的疗效。本文总结了与肠道菌群对 CRC 患者抗 PD-1/PD-L1 抗体疗效影响相关的研究，并探讨了潜在的机制。我们重点关注了肠道菌群对 CRC 患者抗 PD-1/PD-L1 抗体疗效和安全性的影响，以及如何更好地利用肠道菌群作为辅助手段来提高抗 PD-1/PD-L1 抗体的疗效。此外，我们为肠道菌群作为一种新的治疗方式和判断患者预后的指标提供了依据。
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