Interactions between Dietary Micronutrients, Composition of the Microbiome and Efficacy of Immunotherapy in Cancer Patients

SIMPLE SUMMARY: Immunotherapy is a systemic therapy significant for numerous types of cancer. The search for factors which may improve the effectiveness of the therapy is still ongoing. The correlation between host microbiome and the efficacy of immunotherapy has been confirmed. Nutrients modulate the composition of the microbiome, which can be used to improve treatment. The paper presents the impact of probiotics, prebiotics and micronutrients on particular species of bacteria associated with a significant increase in response to anti-PD1, anti-PD-L1 and anti-CTLA4 immunotherapy. We also present our own investigation on the relationship between the gut microbiome and the effectiveness of immunotherapy in non-small-cell lung cancer patients. ABSTRACT: The effectiveness of immunotherapy in cancer patients depends on the activity of the host’s immune system. The intestinal microbiome is a proven immune system modulator, which plays an important role in the development of many cancers and may affect the effectiveness of anti-cancer therapy. The richness of certain bacteria in the gut microbiome (e.g., Bifidobacterium spp., Akkermanisa muciniphila and Enterococcus hire) improves anti-tumor specific immunity and the response to anti-PD-1 or anti-PD-L1 immunotherapy by activating antigen-presenting cells and cytotoxic T cells within the tumor. Moreover, micronutrients affect directly the activities of the immune system or regulate their function by influencing the composition of the microbiome. Therefore, micronutrients can significantly influence the effectiveness of immunotherapy and the development of immunorelated adverse events. In this review, we describe the relationship between the supply of microelements and the abundance of various bacteria in the intestinal microbiome and the effectiveness of immunotherapy in cancer patients. We also point to the function of the immune system in the case of shifts in the composition of the microbiome and disturbances in the supply of microelements. This may in the future become a therapeutic target supporting the effects of immunotherapy in cancer patients.