Background/Objectives: The gut microbiome influences melanoma biology and response to immune checkpoint inhibitors. Dietary fiber is a key modifiable factor that shapes the microbial composition and metabolite production. This review summarizes mechanistic, preclinical, and clinical evidence describing how fiber and fiber-responsive taxa may affect melanoma immunity and treatment outcomes.Methods: A literature search of MEDLINE, Embase, and Scopus identified studies published within the past five years examining dietary fiber, gut microbiome interactions, immune modulation, or melanoma outcomes. After screening 491 unique records, 49 peer-reviewed mechanistic, preclinical, observational, and interventional studies were synthesized qualitatively in this narrative review.Results: Fiber fermentation produces short-chain fatty acids that regulate dendritic cell activation, T-cell priming, and cytokine signaling. Preclinical melanoma models show that fibers such as inulin and β-glucan enhance IFN-γ-driven antitumor immunity, increase CD8+infiltration, and improve checkpoint blockade efficacy in a microbiota-dependent manner. In humans, fiber-rich diets and enrichment of taxa such asBifidobacterium,Faecalibacterium, andAkkermansiaare associated with improved PD-1 inhibitor responses, longer progression-free survival, and possible reductions in ICI-related colitis. Although epidemiologic studies suggest no clear association between fiber intake and melanoma incidence, dietary fiber intake appears to correlate strongly with treatment-related outcomes.Conclusions: Dietary fiber represents a potentially safe and plausible adjunct to melanoma immunotherapy. However, study variability and emerging counterevidence highlight the need for controlled trials to clarify causality and define optimal fiber-based interventions.
背景/目的：肠道微生物组影响黑色素瘤生物学特性及对免疫检查点抑制剂的应答。膳食纤维是调节微生物组成和代谢产物生成的关键可变因素。本文综述了机制、临床前及临床证据，阐明纤维及纤维响应类群如何影响黑色素瘤免疫及治疗结局。
方法：通过检索MEDLINE、Embase和Scopus数据库，收集近五年内探讨膳食纤维、肠道微生物组互作、免疫调节或黑色素瘤结局的研究。在筛选491条独立记录后，本叙述性综述对49项经同行评议的机制研究、临床前研究、观察性研究及干预性研究进行了定性综合。
结果：纤维发酵产生短链脂肪酸，可调节树突状细胞活化、T细胞启动及细胞因子信号传导。临床前黑色素瘤模型表明，菊粉和β-葡聚糖等纤维能以微生物依赖的方式增强IFN-γ驱动的抗肿瘤免疫、增加CD8+细胞浸润并提升检查点阻断疗效。在人体研究中，富含纤维的饮食以及双歧杆菌、粪杆菌和阿克曼菌等类群的富集，与改善PD-1抑制剂应答、延长无进展生存期以及可能降低免疫检查点抑制剂相关结肠炎风险相关。尽管流行病学研究未发现纤维摄入与黑色素瘤发病率存在明确关联，但膳食纤维摄入量与治疗相关结局呈显著相关性。
结论：膳食纤维可能成为黑色素瘤免疫治疗安全且合理的辅助手段。然而，研究异质性与新出现的反向证据凸显了开展对照试验的必要性，以明确因果关系并确立基于纤维的最佳干预策略。
Dietary Fiber and Melanoma: Exploring Microbiome-Driven Immune Modulation
肿瘤(癌症)患者之家