Microbiota in clinical cancer immunotherapy.
Gut microbiota research has progressed from mechanistic studies to clinical trials, revealing strong potential to enhance cancer immunotherapy.
Fecal microbiota transplantation, single bacterial strains, and defined microbial consortia are in clinical testing; yet, standardization and implementation remain major challenges.
Donor selection, patient enrollment, microbiota implantation, antibiotic use, safety assessment, and endpoint evaluation each offer distinct opportunities and obstacles.
A ‘4D’ framework, enhancing diversity, diffusion, depth, and delicacy, can guide the optimization of microbiomebased immunotherapy. sciencenewshighlights ScienceMission https://sciencemission.com/microbiota-to-clinical-cancer
Fundamental research has elucidated the indispensable role of gut microbiota in modulating cancer immunotherapy efficacy. Despite promising preclinical findings, few related approaches have reached clinical trials. In this opinion, we provide insights based on current clinical trials using fecal microbiota transplant or specific bacterial strains as adjuvants to enhance immune checkpoint blockade therapy. We also systematically analyze the challenges in trial design, with a focus on donor selection, patient enrollment, implantation procedures, antibiotic use, safety assessment, and endpoint evaluation. Moving forward, we offer a comprehensive ‘4D’ framework (diversity, diffusion, depth, and delicacy) for accelerating the bench-to-bedside translation.