The Influence of the Microbiome on Immunotherapy for Gastroesophageal Cancer

SIMPLE SUMMARY: This article delves into the mounting impact of the microbiome on gastroesophageal cancer. Investigating its connection to immunotherapy, this study explores microbial shifts within tumor environments, the gastrointestinal tract, and their consequential effects. Notable associations have surfaced, linking dysbiosis, reduced diversity, treatment resistance, and distinct microbe profiles to improved treatment responses. Comprehending these intricate dynamics holds the key to tailored interventions. The potential of microbiome-based biomarkers is promising for personalized treatment strategies and response prediction. Discussions encompass interventions such as microbiota-based therapeutics and dietary adjustments, which could amplify immunotherapy efficacy by shaping the gut environment. However, realizing the full potential of microbiome-centric approaches hinges on thorough research and substantial clinical trials. This article highlights the evolving role of the microbiome and its dual impact on both gastroesophageal cancer and the efficacy of immunotherapy in reshaping future treatment paradigms. ABSTRACT: Immunotherapy has shown promise as a treatment option for gastroesophageal cancer, but its effectiveness is limited in many patients due to the immunosuppressive tumor microenvironment (TME) commonly found in gastrointestinal tumors. This paper explores the impact of the microbiome on the TME and immunotherapy outcomes in gastroesophageal cancer. The microbiome, comprising microorganisms within the gastrointestinal tract, as well as within malignant tissue, plays a crucial role in modulating immune responses and tumor development. Dysbiosis and reduced microbial diversity are associated with poor response rates and treatment resistance, while specific microbial profiles correlate with improved outcomes. Understanding the complex interactions between the microbiome, tumor biology, and immunotherapy is crucial for developing targeted interventions. Microbiome-based biomarkers may enable personalized treatment approaches and prediction of patient response. Interventions targeting the microbiome, such as microbiota-based therapeutics and dietary modifications, offer the potential for reshaping the gut microbiota and creating a favorable TME that enhances immunotherapy efficacy. Further research is needed to reveal the underlying mechanisms, and large-scale clinical trials will be required to validate the efficacy of microbiome-targeted interventions.