Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review

Emerging evidence underscores gut microbiota’s role in modulating lung cancer immunotherapy outcomes, though specific impacts on immune checkpoint inhibitors (ICIs) and associated adverse events (AEs) require further clarity. This review synthesizes findings from 15 studies examining gut microbiota-...

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Main Authors: Yali Jin, Zhiqian Jie, Xianming Fan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1518474/full
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author Yali Jin
Zhiqian Jie
Xianming Fan
Xianming Fan
author_facet Yali Jin
Zhiqian Jie
Xianming Fan
Xianming Fan
author_sort Yali Jin
collection DOAJ
description Emerging evidence underscores gut microbiota’s role in modulating lung cancer immunotherapy outcomes, though specific impacts on immune checkpoint inhibitors (ICIs) and associated adverse events (AEs) require further clarity. This review synthesizes findings from 15 studies examining gut microbiota-ICI interactions in non-small cell lung cancer (NSCLC), alongside studies investigating antibiotics, proton pump inhibitors (PPIs), probiotics, and diet as modulating factors. Results indicate that Actinobacteria, Bacteroides, and Verrucomicrobiota correlate with positive ICI responses, while Bacillota shows variable associations; notably, Bacillota-enriched patients had fewer immunotherapy-related AEs. The administration of antibiotics and PPIs within a month before ICIs was linked to diminished efficacy, whereas probiotics correlated with enhanced outcomes. Plant-based diets are also aligned with dietary patterns supportive of ICIs. These findings suggest that analyzing gut microbiota composition could improve the ability to predict NSCLC patient responses to ICIs. Additionally, judicious use of antibiotics, PPIs, probiotics, and dietary adjustments may optimize immunotherapy outcomes and mitigate adverse effects.
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spelling doaj-art-d25410ee48b045ab86ea730bb5d9e87d2025-08-20T02:27:13ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15184741518474Gut microbes and immunotherapy for non-small cell lung cancer: a systematic reviewYali Jin0Zhiqian Jie1Xianming Fan2Xianming Fan3Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaInflammation and Allergic Diseases Research Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaEmerging evidence underscores gut microbiota’s role in modulating lung cancer immunotherapy outcomes, though specific impacts on immune checkpoint inhibitors (ICIs) and associated adverse events (AEs) require further clarity. This review synthesizes findings from 15 studies examining gut microbiota-ICI interactions in non-small cell lung cancer (NSCLC), alongside studies investigating antibiotics, proton pump inhibitors (PPIs), probiotics, and diet as modulating factors. Results indicate that Actinobacteria, Bacteroides, and Verrucomicrobiota correlate with positive ICI responses, while Bacillota shows variable associations; notably, Bacillota-enriched patients had fewer immunotherapy-related AEs. The administration of antibiotics and PPIs within a month before ICIs was linked to diminished efficacy, whereas probiotics correlated with enhanced outcomes. Plant-based diets are also aligned with dietary patterns supportive of ICIs. These findings suggest that analyzing gut microbiota composition could improve the ability to predict NSCLC patient responses to ICIs. Additionally, judicious use of antibiotics, PPIs, probiotics, and dietary adjustments may optimize immunotherapy outcomes and mitigate adverse effects.https://www.frontiersin.org/articles/10.3389/fonc.2025.1518474/fullimmunotherapygut microbiotanon-small cell lung cancerimmune checkpoint inhibitorsdietary intervention
spellingShingle Yali Jin
Zhiqian Jie
Xianming Fan
Xianming Fan
Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review
Frontiers in Oncology
immunotherapy
gut microbiota
non-small cell lung cancer
immune checkpoint inhibitors
dietary intervention
title Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review
title_full Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review
title_fullStr Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review
title_full_unstemmed Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review
title_short Gut microbes and immunotherapy for non-small cell lung cancer: a systematic review
title_sort gut microbes and immunotherapy for non small cell lung cancer a systematic review
topic immunotherapy
gut microbiota
non-small cell lung cancer
immune checkpoint inhibitors
dietary intervention
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1518474/full
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AT zhiqianjie gutmicrobesandimmunotherapyfornonsmallcelllungcancerasystematicreview
AT xianmingfan gutmicrobesandimmunotherapyfornonsmallcelllungcancerasystematicreview
AT xianmingfan gutmicrobesandimmunotherapyfornonsmallcelllungcancerasystematicreview