THE MICROBIAL BLUEPRINT OF CANCER: GUT MICROBIOME AS AN ARCHITECT OF TUMOUR FATE AND THERAPEUTIC RESPONSE

Authors

  • SAKSHI WANKHEDE Department of Pharmaceutics Quality Assurances, Datta Meghe College of Pharmacy DMIHER (Deemed to be University), Wardha-442001, Maharashtra, India https://orcid.org/0009-0001-9232-7697
  • MAYUR R. DANDEKAR Department of Pharmaceutical Quality Assurances, Datta Meghe College of Pharmacy DMIHER (Deemed to be University), Wardha-442001, Maharashtra, India https://orcid.org/0009-0009-6345-3158
  • YASH M. SALVE Department of Pharmaceutical Quality Assurances, Datta Meghe College of Pharmacy DMIHER (Deemed to be University), Wardha-442001, Maharashtra, India
  • UMESH B. TELRANDHE Department of Pharmaceutics Quality Assurances, Datta Meghe College of Pharmacy DMIHER (Deemed to be University), Wardha-442001, Maharashtra, India

DOI:

https://doi.org/10.22159/ijap.2026v18i3.55166

Keywords:

Genotoxicity, Radiation, Carcinogenesis, Gut microbiota, Cancer prevention

Abstract

It is now commonly acknowledged that the human gut microbiome, which is made up of a dynamic and complex population of trillions of microbes, plays a significant role in controlling human health and illness. A growing body of research demonstrates its role in the development and spread of many types of cancer, as well as its impact on how well cancer treatments work. Through persistent inflammation, DNA damage, immune evasion, metabolic changes, and epigenetic modifications, dysbiosis—an imbalance in the microbial ecosystem—contributes to carcinogenesis. Additionally, the gut flora influences the toxicity and effectiveness of radiation, immunotherapy, and chemotherapy. This study offers a thorough assessment of recent discoveries relating the gut microbiota to the development of cancer and treatment results. Cancer-specific microbial fingerprints across key tumor types are described, coupled with the mechanistic mechanisms of microbiota-driven carcinogenesis. Probiotics, prebiotics, postbiotics, fecal microbiota transplantation (FMT), and microbiome-targeted therapies are among the new therapeutic approaches that are also rigorously examined. This study highlights prospects for incorporating microbiome science into precision oncology by resolving current obstacles and knowledge gaps, opening the door to individualised cancer prevention and therapy.

References

1. Schwabe RF, Jobin C. The microbiome and cancer. Nat Rev Cancer. 2013 Nov;13(11):800–12. doi:10.1038/nrc3610

2. Gerlach JQ, Griffin MD. The role of microbiota in cancer therapy. Front Microbiol. 2017 Nov 24;8:2309. doi:10.3389/fmicb.2017.02309

3. Gopalakrishnan V, Spencer CN, Nezi L, Reuben A, Andrews MC, Karpinets TV, et al. Gut microbiome modulates response to anti–PD-1 immunotherapy in melanoma patients. Science. 2018 Jan 5;359(6371):97–103. doi:10.1126/science.aad3290

4. Routy B, Le Chatelier E, Derosa L, Duong CPM, Alou MT, Daillère R, et al. Gut microbiome influences efficacy of PD-1–based immunotherapy against epithelial tumors. Science. 2018 Jan 5;359(6371):91–7. doi:10.1126/science.aad3329

5. Vétizou M, Pitt JM, Daillère R, Lepage P, Waldschmitt N, Flament C, et al. Anticancer immunotherapy by CTLA-4 blockade relies on the gut microbiota. Science. 2015 Nov 27;350(6257):1079–84. doi:10.1126/science.aad1329

6. Dubin K, Callahan MK, Ren B, Khanin R, Viale A, Ling L, et al. Intestinal microbiome analyses identify melanoma patients at risk for checkpoint-blockade-induced colitis. Nature. 2016 Feb 4;530(7589):68–72. doi:10.1038/nature16963

7. Feng SM, Li H, Wang Y, Zhang L, Shi Y, Zheng Z, et al. Microbiota in cancer immunotherapy: The implications of gut bacteria in immune checkpoint blockade. J Transl Med. 2019 Mar 19;17:97. doi:10.1186/s12967-019-1895-5

8. Zitvogel L, Daillère R, Roberti MP, Routy B, Kroemer G. The microbiome in cancer immunotherapy: Diagnostic tools and therapeutic strategies. Science. 2018 Mar 23;359(6382):1366–70. doi:10.1126/science.aad4254

9. Taur Y, Coyte K, Schluter J, Robilotti E, Figueroa C, Gjonbalaj M, et al. Intestinal microbiome and the risk of bloodstream infections in cancer patients. Sci Transl Med. 2018 Jan 24;10(447):eaal2717. doi:10.1126/scitranslmed.aal2717

10. Sivan A, Corrales L, Hubert N, Williams JB, Aquino-Michaels K, Earley ZM, et al. Commensal Bifidobacterium promotes antitumor immunity and facilitates anti–PD-L1 efficacy. Science. 2015 Nov 27;350(6264):1084–9. doi:10.1126/science.aac4255

11. Guo Z, Zhang J, Wang Z, Ang K, Liao Z, Chen L, et al. Mechanisms of microbiome modulation of cancer treatment outcomes. J Immunol. 2017 Jan 1;198(1):1–10. doi:10.4049/jimmunol.1601543

12. Marchesi JR, Ravel J. The gut microbiome and cancer. Nat Rev Gastroenterol Hepatol. 2018 Sep;15(9):487–500. doi:10.1038/s41575-018-0027-2

13. Wang T, Fan C, Yao A, Xu X, Zheng G, You Y, et al. The gut microbiome and cancer immunotherapy. Cancer Lett. 2020 Oct 28;484:96–104. doi:10.1016/j.canlet.2020.07.030

14. Dejea CM, Wick EC, Hechenbleikner EM, White JR, Mark Welch JL, Rossetti BJ, et al. Microbiota modulation of T cells in cancer immunotherapy. Nat Commun. 2018 Oct 17;9:4277. doi:10.1038/s41467-018-06765-0

15. Goswami S, Sharma S, Goel S, Dutta A, Arora N, Nair A, et al. Modulation of the gut microbiota enhances anti-cancer immunity. J Clin Invest. 2019 Nov 1;129(11):4674–86. doi:10.1172/JCI130294

16. Puchta A, Naidoo A, Verschoor CP. Modulating the microbiome to enhance cancer immunotherapy. Cell Rep. 2020 Mar 31;31(1):107500. doi:10.1016/j.celrep.2020.107500

17. Haas AR, Zavitsanou AM, Simoni Y, Blazquez AB, Prakadan SM, Chen YY, et al. Gut microbiome manipulation: A future strategy for enhancing cancer therapies. Front Immunol. 2016 Dec 14;7:528. doi:10.3389/fimmu.2016.00528

18. Singh N, Rashid M, Das R, Aggarwal A, Sharma R, Prakash H. Modulating the gut microbiome: A new strategy for enhancing cancer immunotherapy. Expert Rev Anticancer Ther. 2019 Dec;19(12):1077–86. doi:10.1080/14737140.2019.1668690

19. Liu J, Tan Y, Liu Q, Song H, Zhang Y, Wan Y, et al. The gut microbiome modulates the efficacy of anti-cancer therapies. Front Microbiol. 2020 Mar 3;11:536. doi:10.3389/fmicb.2020.00536

20. Vogel A, Pohl AL, Glitza Oliva IC. Cancer therapy and microbiome. J Clin Oncol. 2021 Apr 1;39(10):1070–8. doi:10.1200/JCO.20.02791

21. Schwabe RF, Jobin C. The microbiome and cancer therapy: From a physiological perspective. Cancer Immunol Res. 2020 Apr;8(4):383–91. doi:10.1158/2326-6066.CIR-20-0321

22. Flint HJ, Duncan SH, Scott KP, Louis P. The role of the gut microbiome in maintaining health and disease. Lancet. 2017 Nov 25;390(10095):2174–84. doi:10.1016/S0140-6736(17)30729-6

23. Alves SF, Vieira AL, de Castro IA, Biondi RM. Gut microbiota and colorectal cancer: A review on the current status of understanding the interaction. Dig Dis Sci. 2018 Sep;63(9):2344–53. doi:10.1007/s10620-018-5287-3

24. Le Chatelier E, Nielsen T, Qin J, Prifti E, Hildebrand F, Falony G, et al. Richness of human gut microbiome correlates with metabolic markers. Nature. 2013 Aug 29;500(7464):541–6. doi:10.1038/nature12506

25. Zhang X, Zhang L, Zheng Y, Peng Y, Ye Y, Li H. The impact of gut microbiota on chemotherapy and immunotherapy in cancer. Ther Adv Med Oncol. 2021 Jun 11;13:17588359211020744. doi:10.1177/17588359211020744

26. Easson LC, Jacob H, Gur TL. Microbiome-modulating therapies in cancer. Nat Rev Cancer. 2020 Dec;20(12):751–62. doi:10.1038/s41571-020-00402-2

27. Robles M, Mendeley M, Garcia M, Lopez R. The gut microbiome and its impact on cancer immunotherapy. Immunotherapy. 2019 Jul;11(8):543–53. doi:10.2217/imt-2019-0140

28. Feng Y, Chen D, Wang Y, Ye Y, He Y, Ma G, et al. Microbiome-driven modulation of immune responses and implications for cancer immunotherapy. Mol Cancer Ther. 2020 Apr;19(4):823–31. doi:10.1158/1535-7163.MCT-19-1213

29. West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD. Dietary interventions and microbiome modulation in cancer prevention. Curr Opin Clin Nutr Metab Care. 2017 Jul;20(4):274–81. doi:10.1097/MCO.0000000000000374

30. Viaud S, Saccheri F, Mignot G, Yamazaki T, Daillère R, Hannani D, et al. The intestinal microbiota modulates the anticancer immune effects of cyclophosphamide. Science. 2013 Nov 22;342(6161):971–6. doi:10.1126/science.1240537

31. Lee SH, Golomb LM, Zamarin D, Hadley J, Jiang Y, Kozhaya L, et al. Gut microbiota-dependent generation of anti-cancer immune responses. Cell. 2018 Apr 19;173(3):647–659.e17. doi:10.1016/j.cell.2018.03.010

32. Wu HJ, Ivanov II, Darce J, Hattori K, Shima T, Umesaki Y, et al. Gut microbiota regulates anti-tumour immunity and efficacy of cancer therapeutics. Cell. 2016 Apr 7;165(2):325–38. doi:10.1016/j.cell.2016.03.031

33. Mousa SA, Shakeri A, Rezaei N. Gut microbiota as a new therapeutic target in cancer treatment. Nat Rev Clin Oncol. 2019 Aug;16(8):436–54. doi:10.1038/s41571-019-0170-2

34. Wong MC, Jiang JY, Goggins WB, Liang M, Fang Y, Fung FD, et al. International incidence and mortality trends of liver cancer: A global profile. Sci Rep. 2017 Mar 31;7:45846. doi:10.1038/srep45846

35. Jin C, Lagoudas GK, Zhao C, Bullman S, Bhutani K, Shah SA, et al. Commensal microflora promote lung cancer development via γδ T cells. Cell Host Microbe. 2019 Dec 11;26(6):809–822.e6. doi:10.1016/j.chom.2019.11.007

36. Matson V, Fessler J, Bao R, Chongsuwat T, Zha Y, Alegre ML, et al. The commensal microbiome is associated with anti–PD-1 efficacy in metastatic NSCLC. Science. 2021 Mar 19;371(6529):1109–19. doi:10.1126/science.abd5394

37. Zheng Y, Wang T, Tu X, Huang Y, Zhang H, Tan D, et al. Fecal microbiota transplantation enhances efficacy of anti–PD-1 in NSCLC via microbiota–immune–metabolite axis. Nat Commun. 2022 Mar 15;13:1458. doi:10.1038/s41467-022-29046-5

38. Chahal A, Saini AK, Chhillar AK, Saini RV. Natural antioxidants as defense system against cancer. Asian J Pharm Clin Res. 2018 May;11(5):38–44.

39. Kashyap P, Shikha D, Thakur M, Aneja A. Functionality of apigenin as a potent antioxidant: bioavailability, metabolism, mechanism of action, and in vitro/in vivo studies. J Food Biochem. 2022 Apr;46(4):e13950. doi:10.1111/jfbc.13950

40. Scarfò G, Daniele S, Chelucci E, Papini F, Epifani F, Ruggiero M, Cela V, Franzoni F, Artini PG.

41. Schwabe RF, Jobin C. The microbiome and cancer. Nat Rev Cancer. 2013;13(11):800–812.

42. Garrett WS. Cancer and the microbiota. Science. 2015;348(6230):80–86.

43. Gopalakrishnan V, et al. Gut microbiome modulates response to anti–PD-1 immunotherapy in melanoma patients. Science. 2018;359(6371):97–103.

44. Routy B, et al. Gut microbiome influences efficacy of PD-1–based immunotherapy. Science. 2018;359(6371):91–97.

45. Zitvogel L, et al. Anticancer effects of the microbiome and its products. Nat Rev Microbiol. 2017;15(8):465–478.

46. Louis P, Hold GL, Flint HJ. The gut microbiota, bacterial metabolites and colorectal cancer. Nat Rev Microbiol. 2014;12(10):661–672.

47. Helmink BA, et al. The microbiome, cancer, and cancer therapy. Nat Med. 2019;25(3):377–388.

48. Wang T, et al. Structural segregation of gut microbiota between colorectal cancer patients and healthy volunteers. ISME J. 2012;6(2):320–329.

49. Yu LC, et al. Dysbiosis of gut microbiota in colorectal cancer: mechanisms and clinical implications. Nat Rev Gastroenterol Hepatol. 2017;14(11):646–658.

50. Pushalkar S, et al. The pancreatic cancer microbiome promotes oncogenesis by induction of innate and adaptive immune suppression. Cancer Discov. 2018;8(4):403–416.

51. Viaud S, et al. The intestinal microbiota modulates the anticancer immune effects of cyclophosphamide. Science. 2013;342(6161):971–976.

52. Ma C, et al. Gut microbiome–mediated bile acid metabolism regulates liver cancer via NKT cells. Science. 2018;360(6391):eaan5931.

53. Cullin N, et al. Microbiome and cancer. Cancer Cell. 2021;39(10):1317–1341.

54. Poore GD, et al. Microbiome analyses of blood and tissues suggest cancer diagnostic approach. Nature. 2020;579(7800):567–574.

55. Sepich-Poore GD, et al. The microbiome and human cancer. Science. 2021;371(6536):eabc4552.

56. Sivan A, et al. Commensal Bifidobacterium promotes antitumor immunity and facilitates anti-PD-L1 efficacy. Science. 2015;350(6264):1084–1089.

57. Feng Q, et al. Gut microbiome development along colorectal adenoma–carcinoma sequence. Nat Commun. 2015;6:6528.

58. Tilg H, Adolph TE, Gerner RR, Moschen AR. The intestinal microbiota in colorectal cancer. Cancer Cell. 2018;33(6):954–964.

59. Alexander JL, et al. Gut microbiota modulation of chemotherapy efficacy and toxicity. Nat Rev Gastroenterol Hepatol. 2017;14(6):356–365.

60. Dohlman AB, et al. The cancer microbiome atlas: A pan-cancer resource. Cell Host Microbe. 2021;29(7):1083–1097.

Published

01-04-2026

How to Cite

WANKHEDE, S., DANDEKAR, M. R., SALVE, Y. M., & TELRANDHE, U. B. (2026). THE MICROBIAL BLUEPRINT OF CANCER: GUT MICROBIOME AS AN ARCHITECT OF TUMOUR FATE AND THERAPEUTIC RESPONSE. International Journal of Applied Pharmaceutics, 18(3). https://doi.org/10.22159/ijap.2026v18i3.55166

Issue

Section

Review Article(s)

Most read articles by the same author(s)

Similar Articles

<< < 71 72 73 74 75 > >> 

You may also start an advanced similarity search for this article.