Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India.
Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.
Dent Med Probl. 2024 Sep-Oct;61(5):739-746. doi: 10.17219/dmp/183712.
The complex interplay between the gut microbiota, cancer treatments and patient characteristics has emerged as a significant area of research. This study sought to examine these relationships in the context of colorectal cancer (CRC).A comprehensive search of relevant studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The studies included a variety of treatment modalities and microbiological parameters. A data extraction form, designed specifically for this review, was used to assess a range of variables across all studies.The analysis revealed a multifaceted interaction between the gut microbiota, genetic factors and treatment outcomes. Elderly patients with CRC frequently received single-agent chemotherapy, with outcomes that were comparable to those of younger patients. The presence of tumorigenic bacteria, including Escherichia coli and Bacteroides fragilis, was associated with early colon neoplasia. Additionally, an abundance of Fusobacterium spp. was observed in colonic adenomas, contributing to a pro-inflammatory environment. Although the FcγRIIIa-158 V/V genotype was associated with higher cetuximab-mediated antibodydependent cellular cytotoxicity (ADCC), no direct influence of FcγR polymorphisms on treatment response was noted. Furthermore, the combination of programmed cell death protein-1 (PD-1), BRAF and MEK inhibition showed favorable response rates. The gut microbiome, especially the presence of Fusobacterium spp., had a notable influence on the therapeutic response in CRC.These findings underscore the role of the gut microbiota and genetic factors in cancer treatment outcomes, emphasizing the potential of a holistic approach to cancer management. Future research should exploit these findings in order to develop microbiota-modulating strategies and personalized medicine approaches for the purpose of improving the efficacy of cancer treatment.
肠道微生物群、癌症治疗和患者特征之间的复杂相互作用已成为一个重要的研究领域。本研究旨在探讨结直肠癌（CRC）背景下这些关系。
按照系统评价和荟萃分析的首选报告项目（PRISMA）2020 指南和 Cochrane 系统评价干预手册，对相关研究进行了全面检索。研究包括各种治疗方式和微生物学参数。使用专门为此审查设计的数据提取表格，评估了所有研究的一系列变量。
分析揭示了肠道微生物群、遗传因素和治疗结果之间的多方面相互作用。CRC 老年患者经常接受单一药物化疗，其结果与年轻患者相当。肿瘤细菌（包括大肠杆菌和脆弱拟杆菌）的存在与早期结肠肿瘤有关。此外，在结肠腺瘤中观察到丰度较高的梭菌属 spp.，导致促炎环境。虽然 FcγRIIIa-158 V/V 基因型与更高的西妥昔单抗介导的抗体依赖性细胞毒性（ADCC）相关，但未观察到 FcγR 多态性对治疗反应的直接影响。此外，程序性细胞死亡蛋白-1（PD-1）、BRAF 和 MEK 抑制的联合显示出良好的反应率。肠道微生物组，特别是梭菌属 spp.的存在，对 CRC 的治疗反应有显著影响。
这些发现强调了肠道微生物群和遗传因素在癌症治疗结果中的作用，强调了采用整体方法进行癌症管理的潜力。未来的研究应利用这些发现，开发调节微生物组的策略和个性化医疗方法，以提高癌症治疗的疗效。
