Targeting gut and intratumoral microbiota: a novel strategy to improve therapy resistance in cancer with a focus on urologic tumors

ABSTRACT

Introduction

Growing attention has been drawn to urologic tumors due to their rising incidence and suboptimal clinical treatment outcomes. Cancer therapy resistance poses a significant challenge in clinical oncology, limiting the efficacy of conventional treatments and contributing to disease progression. Recent research has unveiled a complex interplay between the host microbiota and cancer cells, highlighting the role of the microbiota in modulating therapeutic responses.

Areas covered

We used the PubMed and Web of Science search engines to identify key publications in the fields of tumor progression and urologic tumor treatment, specifically focusing on the role of the microbiota. In this review, we summarize the current literature on how microbiota influence the tumor microenvironment and anti-tumor immunity, as well as their impact on treatments for urinary system malignancies, highlighting promising future applications.

Expert opinion

We explore how the composition and function of the gut microbiota influence the tumor microenvironment and immune response, ultimately impacting treatment outcomes. Additionally, we discuss emerging strategies targeting the microbiota to enhance therapeutic efficacy and overcome resistance. The application of antibiotics, fecal microbiota transplantation, and oncolytic bacteria has improved tumor treatment outcomes, which provides a novel insight into developing therapeutic strategies for urologic cancer.

KEYWORDS:

• Gut microbiota
• intratumoral microbiota
• therapy resistance
• tumor microenvironment
• urologic cancer

Article highlights

• In recent years, the clinical treatment of urinary system tumors has frequently been confronted with difficulties such as resistance, often accompanied by low immune response rates and substantial side effects.

• The microbiota, acting directly or indirectly on the tumor microenvironment, can either enhance or weaken anti-tumor immunity.

• Targeting the gut microbiota can help address the challenges of treatment resistance in urinary system cancer, presenting new therapeutic insights for medical practitioners.

• There is an immediate requirement for extensive clinical trials to assess the effectiveness of methods like fecal microbiota transplantation, antibiotics, and probiotics in targeting the microbiota for the treatment of these malignancies.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authorship contributions

B Wu contributed to the conception and design of the study, wrote the original manuscript, and drafted the figures. C Quan, Y He, and J Matsika contributed to the acquisition and interpretation of data and revised the manuscript critically for important intellectual content. J Huang contributed to the conception and design of the study and drafted the figures. B Liu contributed to the conception and design of the study, supervised the project, and provided critical revisions to the manuscript. J Chen contributed to the conception and design of the study, wrote the manuscript, supervised the project, and secured funding. All authors have read and approved the manuscript being submitted, and agree to its submittal to this journal.

Additional information

Funding

This paper was funded by the National Natural Science Foundation of China under Grant 82373337; Natural Science Foundation of Hunan Province under Grant 2023JJ30870; Hunan Province Young talents Program under Grant 2021RC3027; and Central South University Innovation-Driven Research Programme under Grant 2023CXQD071.