Background/Objectives: There is growing interest in the gut microbiome’s role in cancer, particularly its influence on prostate cancer therapy. This review explores how the gut microbiota modulates treatment outcomes and how prostate cancer therapies affect microbial composition.Methods: A semi-systematic PubMed search was performed for English-language articles published between 2010 and 2025 using relevant keywords related to prostate cancer therapy and the gut microbiome. Both original research and reviews were included, with additional studies identified through citation tracking.Results: The literature reveals a dynamic, bidirectional relationship between the gut microbiome and prostate cancer therapies. Gut microbes can modulate treatment efficacy and toxicity through immune regulation, metabolic activity, and the production of bioactive compounds such as short-chain fatty acids and tryptophan derivatives. These interactions influence responses to androgen deprivation therapy, chemotherapy, radiotherapy, and immunotherapy. In parallel, prostate cancer treatments induce notable shifts in gut microbial composition, reducing diversity, increasing intestinal permeability, and promoting dysbiosis. These changes may impair therapeutic outcomes. Specific microbial taxa, includingAkkermansia muciniphila,Faecalibacterium, andBacteroides, have been linked to both therapeutic response and microbiome alterations.Conclusions: The reciprocal influence between gut microbes and prostate cancer therapies presents a compelling avenue for therapeutic innovation. However, current knowledge is largely derived from preclinical or cross-cancer studies, highlighting a major evidence gap in prostate-specific research. Bridging this gap through well-designed translational studies could inform clinical strategies that harness microbiome modulation to enhance treatment efficacy, reduce toxicity, and personalize prostate cancer therapy.
背景/目的：肠道微生物组在癌症中的作用日益受到关注，尤其在前列腺癌治疗中的影响。本综述探讨了肠道菌群如何调节治疗结果，以及前列腺癌疗法如何影响微生物组成。 方法：通过PubMed数据库进行半系统性检索，纳入2010年至2025年间发表的英文文献，检索词涵盖前列腺癌治疗与肠道微生物组相关关键词。同时纳入原始研究和综述类文献，并通过引文追踪补充相关研究。 结果：文献揭示了肠道微生物组与前列腺癌疗法之间存在动态的双向关系。肠道微生物可通过免疫调节、代谢活动以及产生短链脂肪酸和色氨酸衍生物等生物活性化合物，调节治疗效果和毒性。这些相互作用影响对雄激素剥夺疗法、化疗、放疗和免疫疗法的反应。同时，前列腺癌治疗会显著改变肠道微生物组成，降低多样性、增加肠道通透性并促进菌群失调，这些变化可能损害治疗效果。特定微生物类群（如嗜黏蛋白阿克曼菌、粪杆菌属和拟杆菌属）与治疗反应及微生物组改变均存在关联。 结论：肠道微生物与前列腺癌疗法之间的相互影响为治疗创新提供了重要方向。然而，现有认知主要来源于临床前研究或跨癌种研究，凸显了前列腺癌特异性研究领域的重大证据缺口。通过设计严谨的转化研究填补这一空白，可为临床策略提供依据，从而利用微生物组调节提升治疗效果、降低毒性并实现前列腺癌个体化治疗。
Modulating Prostate Cancer Therapy Through the Gut Microbiome: A Comprehensive Review
肿瘤(癌症)患者之家