调节肠道微生物群对癌症患者免疫疗法疗效的影响--最新文献调查。

Stella Ziegler, Stefan Bereswill, Markus M Heimesaat
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摘要

随着目前癌症个体化治疗的发展,免疫疗法等有针对性的专门治疗方案越来越重要,提高其疗效的因素也成为实际研究的重点。鉴于肠道微生物群与宿主免疫的协调互动,人类肠道微生物群的调节是一种治疗增强因素。因此,我们对癌症患者免疫治疗期间肠道微生物群组成的作用及其调节效果进行了实际文献调查。过去 10 年间发表的 23 项研究显示,包括普氏粪杆菌和双歧杆菌在内的不同细菌种类和菌属分别增强了 PD-1/PD-L1 和 CTLA-4 阻断后不同的免疫治疗反应,例如,从而改善了癌症患者的临床预后。相反,肠道中大量存在类杆菌和镰刀菌则会降低免疫疗法的效率,导致无进展生存期缩短。总之,通过粪便微生物群移植或应用益生菌化合物来改变肠道微生物群是癌症患者免疫疗法的潜在辅助选择,这需要在未来的试验中进一步研究,以便为癌症患者提供量身定制的安全辅助治疗措施。
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Modulation of the intestinal microbiota impacts the efficacy of immunotherapy in cancer patients - A recent literature survey.

In line with the current development of individualized cancer treatments, targeted and specialized therapeutic regimens such as immunotherapy gain importance and factors improving its efficacy come into the focus of actual research. Given the orchestrated interaction of the intestinal microbiota with host immunity the modulation of the human gut microbiota represents a therapy-enhancing factor. We therefore performed an actual literature survey on the role of the gut microbiota composition and the effects of its modification during immunotherapy of cancer patients. The included 23 studies published in the past 10 years revealed that both, distinct bacterial species and genera including Faecalibacterium prausnitzii and Bifidobacterium, respectively, enhanced distinct immunotherapy responses following PD-1/PD-L1 and CTLA-4 blockage, for instance, resulting in a better clinical outcome of cancer patients. Conversely, a high intestinal abundance of Bacteroidetes and Fusobacterium species correlated with a less efficient immunotherapy resulting in shorter progress-free survival outcomes. In conclusion, modifications of the gut microbiota by fecal microbiota transplantation or application of probiotic compounds represent potential adjunct options for immunotherapy in cancer patients which needs to be further addressed in future trials to provide individually tailored and safe adjuvant therapeutic measures in the combat of cancer.

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