Microbiota-Mediated Mechanisms in Cancer Therapy

The human microbiota exerts profound influences on the efficacy and tolerability of anticancer treatments through a variety of interlinked mechanisms. Commensal bacteria can modulate drug metabolism, either activating prodrugs or degrading active compounds, thereby altering systemic exposure. Microbial metabolites such as short-chain fatty acids and secondary bile acids shape the tumour microenvironment by influencing immune cell recruitment, epithelial barrier integrity and local inflammation. Key commensals prime innate and adaptive immunity, enhancing antigen presentation and cytotoxic T-cell responses that underpin the success of immune checkpoint inhibitors. Conversely, dysbiosis may foster chronic inflammation, promote chemoresistance and exacerbate mucosal toxicity. Therapeutic interventions—including probiotics, prebiotics, antibiotics, dietary modulation and faecal microbiota transplantation—seek to restore microbial balance, reduce side effects such as mucositis and enhance antitumour immunity. Integrating microbiota profiling into personalised oncology promises to refine treatment selection and predict patient response, offering a novel avenue to improve clinical outcomes across chemotherapy, radiotherapy and immunotherapy modalities.

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Microbiota-Mediated Mechanisms in Cancer Therapy publication trend

The graph below shows the total number of articles in microbiota-mediated mechanisms in cancer therapy across all publications each year (not limited to Nature Index journals).

Technical terms

Dysbiosis: An imbalance in microbial composition that disrupts host–microbe homeostasis and may promote inflammation.

Pharmacomicrobiomics: The study of interactions between drugs and the microbiota that affect pharmacokinetics and pharmacodynamics.

Faecal microbiota transplantation (FMT): The transfer of stool from a healthy donor to a recipient to restore microbial diversity and function.

Immune checkpoint inhibitors: Therapeutic antibodies targeting regulatory pathways in T cells to enhance antitumour immunity.

Short-chain fatty acids (SCFAs): Metabolic by-products of microbial fermentation that influence immune regulation and epithelial health.

Microbial metabolites: Small molecules produced by bacteria, such as secondary bile acids, that modulate the tumour microenvironment.

References

1. Pharmacomicrobiomics: exploiting the drug-microbiota interactions in anticancer therapies. Microbiome (2018).
2. Gut Microbiota Shapes the Efficiency of Cancer Therapy. Frontiers in Microbiology (2019).
3. Emerging role of human microbiome in cancer development and response to therapy: special focus on intestinal microflora. Journal of Translational Medicine (2022).