越来越多的证据表明，肠道菌群调节癌症治疗的疗效和毒性，尤其是免疫疗法及其免疫相关的不良作用。接受抗生素治疗的患者对免疫治疗的反应不佳支持了肠道菌群在其中发挥影响的重要角色。直到最近，有关鉴定导致这些影响的微生物物种的结果不一致，而且分析相关机制的研究相对较少。现在，已经更好地了解了涉及的物种分类以及行动机制。已经证明，特定的细菌物种通过产生不同的产物或代谢产物来促进免疫检查点抑制剂的改善反应。然而，革兰氏阴性菌的抑制作用可能在某些不响应的患者中占主导地位。机器学习方法通过对患者肠道菌群组成的训练可以有一定准确性预测患者对免疫治疗的反应能力。因此，越来越多的人对调节肠道菌群组成以提高患者对治疗的反应性感兴趣。临床概念证明研究已经证明，排便菌移植或饮食干预在癌症患者中可以被用来提高免疫治疗的成功率。在这里，我们回顾最近的进展并讨论基于菌群的癌症治疗的新策略。© 2022。这是美国政府的工作，不受版权保护；可能适用于外国版权保护。

Growing evidence suggests that the gut microbiota modulates the efficacy and toxicity of cancer therapy, most notably immunotherapy and its immune-related adverse effects. The poor response to immunotherapy in patients treated with antibiotics supports this influential role of the microbiota. Until recently, results pertaining to the identification of the microbial species responsible for these effects were incongruent, and relatively few studies analysed the underlying mechanisms. A better understanding of the taxonomy of the species involved and of the mechanisms of action has since been achieved. Defined bacterial species have been shown to promote an improved response to immune-checkpoint inhibitors by producing different products or metabolites. However, a suppressive effect of Gram-negative bacteria may be dominant in some unresponsive patients. Machine learning approaches trained on the microbiota composition of patients can predict the ability of patients to respond to immunotherapy with some accuracy. Thus, interest in modulating the microbiota composition to improve patient responsiveness to therapy has been mounting. Clinical proof-of-concept studies have demonstrated that faecal microbiota transplantation or dietary interventions might be utilized clinically to improve the success rate of immunotherapy in patients with cancer. Here, we review recent advances and discuss emerging strategies for microbiota-based cancer therapies.© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.