Role of the gut microbiome for cancer patients receiving immunotherapy: Dietary and treatment implications.
Animals
Anti-Bacterial Agents
/ adverse effects
Bacteria
/ drug effects
Diet
/ adverse effects
Dietary Supplements
Dysbiosis
Fecal Microbiota Transplantation
Gastrointestinal Microbiome
/ drug effects
Host-Pathogen Interactions
Humans
Immune Checkpoint Inhibitors
/ adverse effects
Immunotherapy
/ adverse effects
Neoplasms
/ drug therapy
Nutritional Status
Proton Pump Inhibitors
/ adverse effects
Antibiotics
Gut microbiome
Immunotherapy
Microbiota
Nutrition
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
05
01
2020
revised:
01
07
2020
accepted:
22
07
2020
pubmed:
6
9
2020
medline:
26
1
2021
entrez:
5
9
2020
Statut:
ppublish
Résumé
Immune-checkpoint inhibitors (ICIs) have revolutionised the therapeutic landscape for multiple malignancies and the health of the gut microbiome (GM) is strongly linked with therapeutic responses to ICI. This review explores the implications of diet and medication on the GM for patients receiving ICI. Clinical trials are underway to explore the impact of factors such as faecal microbiota transfer, probiotics, prebiotics, bacteria consortia and a number of dietary interventions on patients receiving ICI. Randomised controlled trials are lacking, and inferences are currently based on short-term clinical and observational studies. Antibiotics should be avoided before ICI initiation, and depending on prospective data, future consideration may be given to temporary delay of initiation of non-urgent ICI if patient has had broad spectrum antibiotics within 1 month of planned treatment initiation. Proton pump inhibitor use should be discontinued when not clearly indicated and potential switch to a histamine H2-receptor antagonist considered. Patients should be advised to minimise animal meat intake and maximise plants, aiming to consume ≥30 plant types weekly. A high fibre intake (>30 g/day) has been seen to be beneficial in increasing the chance of ICI response. Fermented foods may have a beneficial effect on the GM and should be introduced where possible. Ideally, all patients should be referred to a nutritionist or dietician with knowledge of GM before commencing ICI.
Identifiants
pubmed: 32889369
pii: S0959-8049(20)30426-3
doi: 10.1016/j.ejca.2020.07.026
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Immune Checkpoint Inhibitors
0
Proton Pump Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
149-155Subventions
Organisme : Medical Research Council
ID : MR/N01183X/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N030125/1
Pays : United Kingdom
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement The authors feel there are no conflicts relevant to this letter, but here are their conflicts: K.A.L. has nothing to disclose. T.D.S. has nothing to disclose. H.S. reports personal fees from Novartis, MSD, BMS, Sanofi-Genzyme, Genmab, clinical/data manager funding from Roche, Merck, Immunocore; project manager funding from BMS, NMP funding from Novartis. V.B. reports personal fees from BMS and Novartis. P.N. reports personal fees from AstraZeneca, BMS, Merck, Immunocore, Pfizer, Ipsen, 4SC, Pierre Fabre and Roche.