From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy
The integration of fecal microbiota transplantation (FMT) with immune checkpoint inhibitors (ICIs) presents a promising approach for enhancing cancer treatment efficacy and overcoming therapeutic resistance. This review critically examines the controversial effects of FMT on ICIs outcomes and elucid...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Gut Microbes |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/19490976.2025.2452277 |
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| author | Anqi Lin Aimin Jiang Lihaoyun Huang Yu Li Chunyanx Zhang Lingxuan Zhu Weiming Mou Zaoqu Liu Jian Zhang Quan Cheng Ting Wei Peng Luo |
| author_facet | Anqi Lin Aimin Jiang Lihaoyun Huang Yu Li Chunyanx Zhang Lingxuan Zhu Weiming Mou Zaoqu Liu Jian Zhang Quan Cheng Ting Wei Peng Luo |
| author_sort | Anqi Lin |
| collection | DOAJ |
| description | The integration of fecal microbiota transplantation (FMT) with immune checkpoint inhibitors (ICIs) presents a promising approach for enhancing cancer treatment efficacy and overcoming therapeutic resistance. This review critically examines the controversial effects of FMT on ICIs outcomes and elucidates the underlying mechanisms. We investigate how FMT modulates gut microbiota composition, microbial metabolite profiles, and the tumor microenvironment, thereby influencing ICIs effectiveness. Key factors influencing FMT efficacy, including donor selection criteria, recipient characteristics, and administration protocols, are comprehensively discussed. The review delineates strategies for optimizing FMT formulations and systematically monitoring post-transplant microbiome dynamics. Through a comprehensive synthesis of evidence from clinical trials and preclinical studies, we elucidate the potential benefits and challenges of combining FMT with ICIs across diverse cancer types. While some studies report improved outcomes, others indicate no benefit or potential adverse effects, emphasizing the complexity of host-microbiome interactions in cancer immunotherapy. We outline critical research directions, encompassing the need for large-scale, multi-center randomized controlled trials, in-depth microbial ecology studies, and the integration of multi-omics approaches with artificial intelligence. Regulatory and ethical challenges are critically addressed, underscoring the imperative for standardized protocols and rigorous long-term safety assessments. This comprehensive review seeks to guide future research endeavors and clinical applications of FMT-ICIs combination therapy, with the potential to improve cancer patient outcomes while ensuring both safety and efficacy. As this rapidly evolving field advances, maintaining a judicious balance between openness to innovation and cautious scrutiny is crucial for realizing the full potential of microbiome modulation in cancer immunotherapy. |
| format | Article |
| id | doaj-art-8b8a3c1e940848268af341e11aee2ac7 |
| institution | Kabale University |
| issn | 1949-0976 1949-0984 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Gut Microbes |
| spelling | doaj-art-8b8a3c1e940848268af341e11aee2ac72025-01-18T17:05:29ZengTaylor & Francis GroupGut Microbes1949-09761949-09842025-12-0117110.1080/19490976.2025.2452277From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacyAnqi Lin0Aimin Jiang1Lihaoyun Huang2Yu Li3Chunyanx Zhang4Lingxuan Zhu5Weiming Mou6Zaoqu Liu7Jian Zhang8Quan Cheng9Ting Wei10Peng Luo11Department of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Urology, Changhai hospital, Naval Medical University (Second Military Medical University), Shanghai, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaInstitute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaDepartment of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, Guangdong, ChinaThe integration of fecal microbiota transplantation (FMT) with immune checkpoint inhibitors (ICIs) presents a promising approach for enhancing cancer treatment efficacy and overcoming therapeutic resistance. This review critically examines the controversial effects of FMT on ICIs outcomes and elucidates the underlying mechanisms. We investigate how FMT modulates gut microbiota composition, microbial metabolite profiles, and the tumor microenvironment, thereby influencing ICIs effectiveness. Key factors influencing FMT efficacy, including donor selection criteria, recipient characteristics, and administration protocols, are comprehensively discussed. The review delineates strategies for optimizing FMT formulations and systematically monitoring post-transplant microbiome dynamics. Through a comprehensive synthesis of evidence from clinical trials and preclinical studies, we elucidate the potential benefits and challenges of combining FMT with ICIs across diverse cancer types. While some studies report improved outcomes, others indicate no benefit or potential adverse effects, emphasizing the complexity of host-microbiome interactions in cancer immunotherapy. We outline critical research directions, encompassing the need for large-scale, multi-center randomized controlled trials, in-depth microbial ecology studies, and the integration of multi-omics approaches with artificial intelligence. Regulatory and ethical challenges are critically addressed, underscoring the imperative for standardized protocols and rigorous long-term safety assessments. This comprehensive review seeks to guide future research endeavors and clinical applications of FMT-ICIs combination therapy, with the potential to improve cancer patient outcomes while ensuring both safety and efficacy. As this rapidly evolving field advances, maintaining a judicious balance between openness to innovation and cautious scrutiny is crucial for realizing the full potential of microbiome modulation in cancer immunotherapy.https://www.tandfonline.com/doi/10.1080/19490976.2025.2452277Fecal Microbiota Transplantationimmune checkpoint inhibitorscontroversial effectscancer immunotherapymicrobiome modulation |
| spellingShingle | Anqi Lin Aimin Jiang Lihaoyun Huang Yu Li Chunyanx Zhang Lingxuan Zhu Weiming Mou Zaoqu Liu Jian Zhang Quan Cheng Ting Wei Peng Luo From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy Gut Microbes Fecal Microbiota Transplantation immune checkpoint inhibitors controversial effects cancer immunotherapy microbiome modulation |
| title | From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy |
| title_full | From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy |
| title_fullStr | From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy |
| title_full_unstemmed | From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy |
| title_short | From chaos to order: optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy |
| title_sort | from chaos to order optimizing fecal microbiota transplantation for enhanced immune checkpoint inhibitors efficacy |
| topic | Fecal Microbiota Transplantation immune checkpoint inhibitors controversial effects cancer immunotherapy microbiome modulation |
| url | https://www.tandfonline.com/doi/10.1080/19490976.2025.2452277 |
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