Darawshy Fares, Tsay Jun-Chieh J, Segal Leopoldo N, Pass Harvey
Division of Pulmonary and Critical Care Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
Hadassah Medical Center, The Institute of Pulmonary Medicine, Jerusalem, Israel.
Cancer Biomark. 2025 Apr;42(4):18758592251322045. doi: 10.1177/18758592251322045. Epub 2025 Apr 29.
Non-small cell lung cancer (NSCLC) remains the most common cause for cancer-related mortality despite advances in treatment. Early detection is crucial for improving patient outcomes, yet current diagnostic and prognostic molecular biomarkers lack the sensitivity and specificity necessary to become clinically useful. Recent studies revealed that the lower airway microbiome play a role in NSCLC and that microbial signatures are associated with NSCLC development, progression, and prognosis, suggesting the potential for microbiome-based biomarkers for early diagnosis and risk stratification. Here we review recent advances in the role of the local and systemic microbiome in early-stage NSCLC. Primarily, several studies have identified specific microbial taxa associated with lung cancer suggesting novel insights into disease pathogenesis and progression. Integration of microbiome data with other 'omics' platforms, such as host transcriptomics and metabolomics, has the potential to enhance our understanding of microbial-host interactions and may provide more comprehensive biomarker signatures. While promising, challenges remain to the development of microbiome-based biomarkers such as those related to differences in samples utilized, sequencing methods, and data analysis. Here, we discuss such challenges as well as future directions for research needed to fulfil the promise of microbiome-based biomarkers for changing early detection and management strategies in NSCLC.
尽管治疗方面取得了进展，但非小细胞肺癌（NSCLC）仍然是癌症相关死亡的最常见原因。早期检测对于改善患者预后至关重要，然而目前的诊断和预后分子生物标志物缺乏成为临床有用标志物所需的敏感性和特异性。最近的研究表明，下呼吸道微生物群在NSCLC中起作用，并且微生物特征与NSCLC的发生、发展和预后相关，这表明基于微生物群的生物标志物在早期诊断和风险分层方面具有潜力。在此，我们综述了局部和全身微生物群在早期NSCLC中作用的最新进展。首先，多项研究已经确定了与肺癌相关的特定微生物分类群，这为疾病的发病机制和进展提供了新的见解。将微生物群数据与其他“组学”平台（如宿主转录组学和代谢组学）整合，有可能增强我们对微生物-宿主相互作用的理解，并可能提供更全面的生物标志物特征。尽管前景广阔，但基于微生物群的生物标志物的开发仍面临挑战，例如与所用样本差异、测序方法和数据分析相关的挑战。在此，我们讨论这些挑战以及为实现基于微生物群的生物标志物在改变NSCLC早期检测和管理策略方面的前景所需的未来研究方向。
