Targeting the gut microbiota to alleviate chemotherapy-induced toxicity in cancer

Abstract

Despite ongoing breakthroughs in novel anticancer therapies, chemotherapy remains a mainstream therapeutic modality in different types of cancer. Unfortunately, chemotherapy-related toxicity (CRT) often leads to dose limitation, and even results in treatment termination. Over the past few years, accumulating evidence has indicated that the gut microbiota is extensively engaged in various toxicities initiated by chemotherapeutic drugs, either directly or indirectly. The gut microbiota can now be targeted to reduce the toxicity of chemotherapy. In the current review, we summarized the clinical relationship between the gut microbiota and CRT, as well as the critical role of the gut microbiota in the occurrence and development of CRT. We then summarized the key mechanisms by which the gut microbiota modulates CRT. Furthermore, currently available strategies to mitigate CRT by targeting the gut microbiota were summarized and discussed. This review offers a novel perspective for the mitigation of diverse chemotherapy-associated toxic reactions in cancer patients and the future development of innovative drugs or functional supplements to alleviate CRT via targeting the gut microbiota.

Keywords:

• Gut microbiota
• cancer
• chemotherapy-related toxicity
• individualized medication

Author contributions

Y.X., Z.X., and Y.H. conceived this study. Y.X. performed the literature searches and drafted the manuscript. Y.H. and Z.X. provided significant feedback and edited the manuscript. H.D., Y.C., C.M., Q.Z., and H.L. revised the manuscript. All authors contributed to the article and have given their approval to submit the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was funded by the Natural Science Foundation of Guangdong Province [Grant No. 2023A1515012418], and the Fundamental Research Funds for the Central Universities, Sun Yat-sen University [Grant No. 22qntd4601].