Despite the recent availability of immune checkpoint inhibitors, not all patients affected by Non-Small-Cell Lung Cancer (NSCLC) benefit from immunotherapy. The reason for this variability relies on a variety of factors which may allow for the identification of novel biomarkers. Presently, a variety of biomarkers are under investigation, including the PD1/PDL1 axis, the tumor mutational burden, and the microbiota. The latter is made by all the bacteria and other microorganisms hosted in our body. The gut microbiota is the most represented and has been involved in different physiological and pathological events, including cancer. In this light, it appears that all conditions modifying the gut microbiota can influence cancer, its treatment, and its treatment-related toxicities. The aim of this review is to analyze all the conditions influencing the gut microbiota and, therefore, affecting the response to immunotherapy, iRAEs, and their management in NSCLC patients. The investigation of the landscape of these biological events can allow for novel insights into the optimal management of NSCLC immunotherapy.
尽管近年来免疫检查点抑制剂已投入使用，但并非所有非小细胞肺癌（NSCLC）患者均能从免疫治疗中获益。这种疗效差异源于多种因素，这些因素可能为新型生物标志物的发现提供线索。目前正在研究的生物标志物包括PD1/PDL1信号轴、肿瘤突变负荷及微生物群等。微生物群由人体内所有细菌及其他微生物构成，其中肠道微生物群数量最为庞大，参与包括癌症在内的多种生理及病理过程。由此可见，任何改变肠道微生物群的因素都可能影响癌症的发生发展、治疗效果及治疗相关毒性。本综述旨在系统分析影响肠道微生物群的各种因素，进而探讨这些因素如何调节NSCLC患者对免疫治疗的反应、免疫相关不良事件（iRAEs）及其临床管理策略。通过对这些生物学事件的全面梳理，可为优化NSCLC免疫治疗提供新的见解。
肿瘤(癌症)患者之家