Impact of gut microbiome in the development and treatment of pancreatic cancer: Newer insights

Abstract

The gut microbiome plays an important role in the variation of pharmacologic response. This aspect is especially important in the era of precision medicine, where understanding how and to what extent the gut microbiome interacts with drugs and their actions will be key to individualizing therapy. The impact of the composition of the gut microbiome on the efficacy of newer cancer therapies such as immune checkpoint inhibitors and chimeric antigen receptor T-cell treatment has become an active area of research. Pancreatic adenocarcinoma (PAC) has a poor prognosis even in those with potentially resectable disease, and treatment options are very limited. Newer studies have concluded that there is a synergistic effect for immunotherapy in combination with cytotoxic drugs, in the treatment of PAC. A variety of commensal microbiota can affect the efficacy of conventional chemotherapy and immunotherapy by modulating the tumor microenvironment in the treatment of PAC. This review will provide newer insights on the impact that alterations made in the gut microbial system have in the development and treatment of PAC.

Editor-in-Chief articles of choice and comments at the year-end of 2023

“…WJG v29i25: I have reviewed all the articles and found them interesting overall. I especially like the paper titled “Impact of gut microbiome in the development and treatment of pancreatic cancer: Newer insights”[ 47 ]. The Reviews are mostly reasonable, and so is the timeline of publication.…”

Emerging Therapeutic Options in Pancreatic Cancer Management

“…In this regard, Makler and colleagues identified four distinct differentially expressed miRNAs between plasma exosomes harvested from PDAC patients and those from control patients: miR-93-5p, miR-339-3p, miR-425-5p, and miR-425-3p, with an area under the curve (AUC) of the receiver operator characteristic curve (ROC) of 0.885, a sensitivity of 80%, and a specificity of 94.7%, which is comparable to the CA19-9 standard PDAC marker diagnostic [28]. Recently, the composition of the tumor microbiome has emerged as a novel prognostic factor for PDAC, as it differs from one patient to another and in response to chemotherapy [29][30][31][32]. Merali et al demonstrated the existence of a bile microbiome signature in patients with PDAC who experienced obstructive jaundice caused by the disease, and the identification of specific bacteria in the bile has the potential to facilitate the detection and stratification of PDAC [33].…”