Huang Lihaoyun, Li Yu, Zhang Chunyan, Jiang Aimin, Zhu Lingxuan, Mou Weiming, Li Kailai, Zhang Jian, Cui Cui, Cui Xinfang, Lin Anqi, Luo Peng, Wei Ting
Department of Oncology, Zhujiang Hospital, Southern Medical University; Donghai County People's Hospital (Affiliated Kangda College of Nanjing Medical University), Lianyungang, China.
Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
NPJ Biofilms Microbiomes. 2025 Sep 2;11(1):180. doi: 10.1038/s41522-025-00819-2.
Immune checkpoint inhibitors (ICIs) have revolutionized cancer immunotherapy, with the microbiome significantly influencing treatment outcomes. Analysis of 4663 studies (2014.01-2024.10) identified 71 eligible randomized controlled trials (RCTs) and cohort studies (41 viral, 30 bacterial). Analyses included subgroup assessments by cancer type, microbial taxa, and ICI regimens. Among 4663 identified studies, 71 met inclusion criteria (41 viral, 30 bacterial). Viral status, particularly hepatitis B virus (HBV) and human papillomavirus (HPV), significantly associated with ORR and DCR. Bacterial enrichment correlated with improved survival in hepatobiliary (OS: HR = 4.33, 95%CI: 2.20-8.50) and lung cancers (PFS: HR = 1.70, 95%CI: 1.04-2.78). Multi-microbiome models demonstrated superior outcome prediction, with microbial diversity correlating with improved PFS (HR = 0.64, 95%CI: 0.42-0.98). Viral status showed cancer-specific associations with SAEs. The microbiome serves as a valuable predictor of ICI outcomes. Future studies should emphasize large-scale RCTs, standardized assessment methods, and host-microbiome interactions.
免疫检查点抑制剂（ICIs）彻底改变了癌症免疫治疗，微生物群对治疗结果有显著影响。对4663项研究（2014年1月至2024年10月）的分析确定了71项符合条件的随机对照试验（RCTs）和队列研究（41项病毒相关、30项细菌相关）。分析包括按癌症类型、微生物分类群和ICI方案进行亚组评估。在4663项已确定的研究中，71项符合纳入标准（41项病毒相关、30项细菌相关）。病毒状态，特别是乙型肝炎病毒（HBV）和人乳头瘤病毒（HPV），与客观缓解率（ORR）和疾病控制率（DCR）显著相关。细菌富集与肝胆癌（总生存期：风险比[HR]=4.33，95%置信区间[CI]：2.20-8.50）和肺癌（无进展生存期：HR=1.70，95%CI：1.04-2.78）的生存期改善相关。多微生物群模型显示出更好的结果预测能力，微生物多样性与无进展生存期改善相关（HR=0.64，95%CI：0.42-0.98）。病毒状态显示出与严重不良事件（SAEs）的癌症特异性关联。微生物群是ICI治疗结果有价值的预测指标。未来的研究应强调大规模RCTs、标准化评估方法以及宿主-微生物群相互作用。
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