Chang Yujie, Long Min, Shan Hanguo, Liu Logen, Zhong Shangwei, Luo Jun-Li
The Cancer Research Institute and the Second Affiliated Hospital, Hengyang Medical School, University of South China (USC), Hunan 421001, China; MOE Key Lab of Rare Pediatric Diseases, Hengyang Medical School, USC, Hunan 421001, China.
The Cancer Research Institute and the Second Affiliated Hospital, Hengyang Medical School, University of South China (USC), Hunan 421001, China; Hunan Provincial Key Laboratory of Basic and Clinical Pharmacological Research of Gastrointestinal Cancer, USC, Hunan 421001, China.
Crit Rev Oncol Hematol. 2025 Apr;208:104629. doi: 10.1016/j.critrevonc.2025.104629. Epub 2025 Jan 27.
Colorectal cancer (CRC) is one of the most prevalent and lethal cancers worldwide, ranking third in incidence and second in mortality. While immunotherapy has shown promise in patients with deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H), its effectiveness in proficient mismatch repair (pMMR) or microsatellite stable (MSS) CRC remains limited. Recent advances highlight the gut microbiota as a potential modulator of anti-tumor immunity. The gut microbiome can significantly influence the efficacy of immune checkpoint inhibitors (ICIs), especially in pMMR/MSS CRC, by modulating immune responses and systemic inflammation. This review explores the role of the gut microbiota in pMMR/MSS CRC, the mechanisms by which it may enhance immunotherapy, and current strategies for microbiota modulation. We discuss the potential benefits of combining microbiota-targeting interventions with immunotherapy to improve treatment outcomes for pMMR/MSS CRC patients.
结直肠癌（CRC）是全球最常见且致命的癌症之一，发病率排名第三，死亡率排名第二。虽然免疫疗法在错配修复缺陷（dMMR）或微卫星高度不稳定（MSI-H）的患者中显示出前景，但其在错配修复 proficient（pMMR）或微卫星稳定（MSS）的结直肠癌中的有效性仍然有限。最近的进展突出了肠道微生物群作为抗肿瘤免疫的潜在调节因子。肠道微生物组可通过调节免疫反应和全身炎症，显著影响免疫检查点抑制剂（ICIs）的疗效，尤其是在pMMR/MSS结直肠癌中。本综述探讨了肠道微生物群在pMMR/MSS结直肠癌中的作用、其增强免疫疗法的机制以及当前微生物群调节策略。我们讨论了将针对微生物群的干预措施与免疫疗法相结合以改善pMMR/MSS结直肠癌患者治疗结果的潜在益处。
