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Review
. 2019 Aug 25;20(17):4145.
doi: 10.3390/ijms20174145.

The Clinical Link between Human Intestinal Microbiota and Systemic Cancer Therapy

Romy Aarnoutse  1   2 , Janine Ziemons  3   4 , John Penders  5   6 , Sander S Rensen  4   6 , Judith de Vos-Geelen  3   7 , Marjolein L Smidt  3   4
Affiliations
Review

The Clinical Link between Human Intestinal Microbiota and Systemic Cancer Therapy

Romy Aarnoutse et al. Int J Mol Sci. .

Abstract

Clinical interest in the human intestinal microbiota has increased considerably. However, an overview of clinical studies investigating the link between the human intestinal microbiota and systemic cancer therapy is lacking. This systematic review summarizes all clinical studies describing the association between baseline intestinal microbiota and systemic cancer therapy outcome as well as therapy-related changes in intestinal microbiota composition. A systematic literature search was performed and provided 23 articles. There were strong indications for a close association between the intestinal microbiota and outcome of immunotherapy. Furthermore, the development of chemotherapy-induced infectious complications seemed to be associated with the baseline microbiota profile. Both chemotherapy and immunotherapy induced drastic changes in gut microbiota composition with possible consequences for treatment efficacy. Evidence in the field of hormonal therapy was very limited. Large heterogeneity concerning study design, study population, and methods used for analysis limited comparability and generalization of results. For the future, longitudinal studies investigating the predictive ability of baseline intestinal microbiota concerning treatment outcome and complications as well as the potential use of microbiota-modulating strategies in cancer patients are required. More knowledge in this field is likely to be of clinical benefit since modulation of the microbiota might support cancer therapy in the future.

Keywords: 16S rRNA gene sequencing; baseline microbiota sampling; chemotherapy; clinical relevance; hormonal therapy; human intestinal microbiota; immunotherapy; longitudinal microbiota sampling; metagenomic sequencing; systemic cancer therapy.

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Conflict of interest statement

Judith de Vos-Geelen has received non-financial support from BTG, and Servier, and has served as a consultant for Shire. Marjolein L. Smidt and Judith de Vos-Geelen received institutional research funding from Servier.

Figures

Figure A1
Figure A1
Risk of bias of six domains assessed by QUIPS.
Figure 1
Figure 1
Overview of the main questions addressed in this review.
Figure 2
Figure 2
Schematic overview of the article selection procedure.
See this image and copyright information in PMC

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