Immunotherapy with immune checkpoint inhibitors represents a revolutionary approach to the treatment of solid tumors, including malignant melanoma, lung cancer, and gastrointestinal malignancies. Anti-CTLA-4 and anti-PD-1/PDL-1 therapies provide prolonged survival for cancer patients, but their efficacy and safety are highly variable. This review focuses on the crucial role of the gut microbiome in modulating the efficacy and toxicity of immune checkpoint blockade. Studies suggest that the composition of the gut microbiome may influence the response to immunotherapy, with specific bacterial strains able to promote an anti-tumor immune response. On the other hand, dysbiosis may increase the risk of adverse effects, such as immune-mediated colitis. Interventions aimed at modulating the microbiome, including the use of probiotics, prebiotics, fecal microbial transplantation, or dietary modifications, represent promising strategies to increase treatment efficacy and reduce toxicity. The combination of immunotherapy with the microbiome-based strategy opens up new possibilities for personalized treatment. In addition, factors such as physical activity and nutritional supplementation may indirectly influence the gut ecosystem and consequently improve treatment outcomes in refractory patients, leading to enhanced patient responses and prolonged survival.
免疫检查点抑制剂疗法代表了一种治疗实体瘤的革命性方法，其应用范围涵盖恶性黑色素瘤、肺癌及胃肠道恶性肿瘤等。抗CTLA-4与抗PD-1/PD-L1疗法虽能为癌症患者带来长期生存获益，但其疗效与安全性存在显著个体差异。本综述聚焦肠道微生物组在调节免疫检查点阻断疗效与毒性中的关键作用。研究表明，肠道微生物组的组成结构可能影响免疫治疗应答，特定菌株能够促进抗肿瘤免疫反应；反之，菌群失调可能增加免疫介导性结肠炎等不良反应风险。通过益生菌、益生元、粪菌移植或饮食调整等干预手段调控微生物组，已成为提升疗效、降低毒性的潜在策略。免疫治疗与微生物组调控的联合应用为个体化治疗开辟了新路径。此外，体力活动与营养补充等因素可能间接影响肠道生态系统，从而改善难治性患者的治疗结局，提升治疗应答率并延长生存期。
肿瘤(癌症)患者之家