Microbiome–tumour interactions
The bacteria in the gut, and even inside tumours, influence whether cancer starts and whether immunotherapy works. Transplanting stool from responders has made some non-responders respond.
Gut microbiota modulate systemic immunity (Bifidobacterium, Akkermansia, Faecalibacterium associated with PD-1 response; antibiotics associated with worse outcomes); faecal microbiota transplant from responders converted a fraction of refractory melanoma patients to responders (2021, and 2023-25 follow-ups). Intratumoural bacteria (Fusobacterium nucleatum in colorectal cancer, Gammaproteobacteria degrading gemcitabine in pancreatic cancer) affect chemoresistance and inflammation; colibactin-producing pks+ E. coli leaves a mutational signature in CRC. 'Polymorphic microbiomes' is a 2022 hallmark. Defined consortia (VE800, SER-155) and diet interventions are in trials; causality beyond melanoma is not settled.
In one picture
Soil bacteria decide whether a garden thrives. Some feed the plants' defenders, some produce poisons, and some even eat the pesticide before it reaches the weeds.
Diagram
top- FMT from responders with PD-1 blockade (phase 2)
- Defined bacterial consortia (VE800, SER-155) and diet (fibre) trials
- Antibiotic stewardship around immunotherapy
- Fusobacterium-targeted strategies (research)
Notes
top- Leading programmes: Wargo (MD Anderson); Zitvogel (Gustave Roussy); Gajewski (Chicago); Sears (Johns Hopkins) on colibactin; Straussman (Weizmann) on intratumoural bacteria.
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