Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)

The impact of the microbiota on radiation (RT)-induced toxicity and cancer response to radiotherapy is an emerging area of interest. In this review, we summarize the available preclinical and clinical evidence concerning microbiota modulation of RT toxicity and efficacy in the main gastrointestinal...

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Main Authors: Marco Lorenzo Bonù, Andrea Georgopulos, Marco Ramera, Jacopo Andreuccetti, Andrea Emanuele Guerini, Anna Maria Bozzola, Vittorio Morelli, Jacopo Balduzzi, Mirsada Katica, Mariateresa Cefaratti, Lorenzo Granello, Luca Triggiani, Michela Buglione, Stefano Maria Magrini, Francesco Marampon, Michele Mondini, Silvana Parisi, Giorgia Timon, Luisa Bellu, Maria Rescigno, Stefano Arcangeli, Marta Scorsetti
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Current Issues in Molecular Biology
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Online Access:https://www.mdpi.com/1467-3045/47/4/265
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author Marco Lorenzo Bonù
Andrea Georgopulos
Marco Ramera
Jacopo Andreuccetti
Andrea Emanuele Guerini
Anna Maria Bozzola
Vittorio Morelli
Jacopo Balduzzi
Mirsada Katica
Mariateresa Cefaratti
Lorenzo Granello
Luca Triggiani
Michela Buglione
Stefano Maria Magrini
Francesco Marampon
Michele Mondini
Silvana Parisi
Giorgia Timon
Luisa Bellu
Maria Rescigno
Stefano Arcangeli
Marta Scorsetti
author_facet Marco Lorenzo Bonù
Andrea Georgopulos
Marco Ramera
Jacopo Andreuccetti
Andrea Emanuele Guerini
Anna Maria Bozzola
Vittorio Morelli
Jacopo Balduzzi
Mirsada Katica
Mariateresa Cefaratti
Lorenzo Granello
Luca Triggiani
Michela Buglione
Stefano Maria Magrini
Francesco Marampon
Michele Mondini
Silvana Parisi
Giorgia Timon
Luisa Bellu
Maria Rescigno
Stefano Arcangeli
Marta Scorsetti
author_sort Marco Lorenzo Bonù
collection DOAJ
description The impact of the microbiota on radiation (RT)-induced toxicity and cancer response to radiotherapy is an emerging area of interest. In this review, we summarize the available preclinical and clinical evidence concerning microbiota modulation of RT toxicity and efficacy in the main gastrointestinal (GI) districts. A huge amount of data supports the clinical application of microbiota modulation, particularly through prebiotics and probiotics, to prevent or mitigate radiotherapy-induced toxicity in rectal cancer. Preclinical and clinical studies also support the observation of microbiota modulation to impact the toxicity and efficacy of treatment in esophageal cancer, hepatocellular carcinoma (HCC), and anal squamous cell carcinoma (ASCC). However, insufficient evidence remains to endorse microbiota modulation as a strategy to enhance tumor radiosensitivity in clinical practice. Well-designed studies focusing on prebiotics, probiotics, and fecal microbiota transplantation are needed across all GI sites to evaluate their potential to improve treatment efficacy, as suggested by promising preclinical findings. The impact of pre-treatment microbiota analyses should be addressed in prospective studies to verify the efficacy of patient-level tailored strategies. Additionally, the repurposing of radioprotective agents with innovative delivery systems, such as encapsulated amifostine, holds significant promise for mitigating small bowel toxicity, thereby enabling more effective RT treatment.
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spelling doaj-art-6d80eb66429c4bbb8f6b0161a7d7c9dc2025-08-20T02:28:19ZengMDPI AGCurrent Issues in Molecular Biology1467-30371467-30452025-04-0147426510.3390/cimb47040265Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)Marco Lorenzo Bonù0Andrea Georgopulos1Marco Ramera2Jacopo Andreuccetti3Andrea Emanuele Guerini4Anna Maria Bozzola5Vittorio Morelli6Jacopo Balduzzi7Mirsada Katica8Mariateresa Cefaratti9Lorenzo Granello10Luca Triggiani11Michela Buglione12Stefano Maria Magrini13Francesco Marampon14Michele Mondini15Silvana Parisi16Giorgia Timon17Luisa Bellu18Maria Rescigno19Stefano Arcangeli20Marta Scorsetti21Department of Radiation Oncology, Istituto del Radio O. Alberti, Spedali Civili Hospital, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Surgery, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Surgery, Spedali Civili Hospital, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Pathology, Spedali Civili Hospital, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiation Oncology, Spedali Civili Hospital and Brescia University, 25123 Brescia, ItalyDepartment of Radiological Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Radiation Oncology, Gustave Roussy Cancer Campus, 94800 Villejuif, FranceRadiation Oncology Unit, Department of Biomedical, Dental Science and Morpological and Functional Images, University of Messina, 98122 Messina, ItalyIRCCS Ospedale Policlinico San Martino, 16132 Genoa, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyIRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyRadiation Oncology Unit, Fondazione IRCCS San Gerardo Dei Tintori, 20900 Monza, ItalyDepartment of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, ItalyThe impact of the microbiota on radiation (RT)-induced toxicity and cancer response to radiotherapy is an emerging area of interest. In this review, we summarize the available preclinical and clinical evidence concerning microbiota modulation of RT toxicity and efficacy in the main gastrointestinal (GI) districts. A huge amount of data supports the clinical application of microbiota modulation, particularly through prebiotics and probiotics, to prevent or mitigate radiotherapy-induced toxicity in rectal cancer. Preclinical and clinical studies also support the observation of microbiota modulation to impact the toxicity and efficacy of treatment in esophageal cancer, hepatocellular carcinoma (HCC), and anal squamous cell carcinoma (ASCC). However, insufficient evidence remains to endorse microbiota modulation as a strategy to enhance tumor radiosensitivity in clinical practice. Well-designed studies focusing on prebiotics, probiotics, and fecal microbiota transplantation are needed across all GI sites to evaluate their potential to improve treatment efficacy, as suggested by promising preclinical findings. The impact of pre-treatment microbiota analyses should be addressed in prospective studies to verify the efficacy of patient-level tailored strategies. Additionally, the repurposing of radioprotective agents with innovative delivery systems, such as encapsulated amifostine, holds significant promise for mitigating small bowel toxicity, thereby enabling more effective RT treatment.https://www.mdpi.com/1467-3045/47/4/265radiotherapymicrobiotagut microbiotamodulation of toxicitymodulation of efficacy
spellingShingle Marco Lorenzo Bonù
Andrea Georgopulos
Marco Ramera
Jacopo Andreuccetti
Andrea Emanuele Guerini
Anna Maria Bozzola
Vittorio Morelli
Jacopo Balduzzi
Mirsada Katica
Mariateresa Cefaratti
Lorenzo Granello
Luca Triggiani
Michela Buglione
Stefano Maria Magrini
Francesco Marampon
Michele Mondini
Silvana Parisi
Giorgia Timon
Luisa Bellu
Maria Rescigno
Stefano Arcangeli
Marta Scorsetti
Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
Current Issues in Molecular Biology
radiotherapy
microbiota
gut microbiota
modulation of toxicity
modulation of efficacy
title Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
title_full Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
title_fullStr Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
title_full_unstemmed Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
title_short Microbiota Modulation of Radiosensitiveness and Toxicity in Gastrointestinal Cancers: What Radiation Oncologists Need to Know—A Review on Behalf of the Italian Association of Radiobiology (AIRB)
title_sort microbiota modulation of radiosensitiveness and toxicity in gastrointestinal cancers what radiation oncologists need to know a review on behalf of the italian association of radiobiology airb
topic radiotherapy
microbiota
gut microbiota
modulation of toxicity
modulation of efficacy
url https://www.mdpi.com/1467-3045/47/4/265
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