Exploring the gut microbiome’s influence on cancer-associated anemia: Mechanisms, clinical challenges, and innovative therapies

Table 2 List of microbiome-targeted therapies with their mechanisms of action and current evidence

Therapy	Mechanism of action	Clinical utility
Probiotics (Lactobacillus, Bifidobacterium)	Restore gut microbial balance, enhance nutrient absorption, reduce inflammation	Improved iron absorption and downregulation of inflammatory cytokines in cancer patients
Prebiotics (dietary fibers, inulin, fructooligosaccharide)	Foster growth of beneficial gut bacteria, increase SCFA production, improve gut barrier function	Superior gut microbiota composition and reduction in anemia severity
Fecal microbiota transplantation	Replenishes beneficial gut microbiota, restores iron metabolism, and reduces inflammation	Improvement in hemoglobin levels and microbiota diversity in anemic patients
Synbiotics (probiotics + prebiotics)	Synergistic effect enhancing microbiota diversity, iron absorption, and immune modulation	Reduction in chemotherapy-induced anemia and gut inflammation
Postbiotics (SCFAs, microbial metabolites)	Modulate immune response, improve iron bioavailability, and suppress inflammation	Enhanced erythropoiesis and reduced systemic inflammation
Dietary interventions (fermented foods, fiber-rich diets, iron and vitamin supplementation)	Support beneficial microbiota, optimize iron and vitamin B12 absorption, reduce gut permeability	Increased erythropoiesis, superior efficacy when combined with probiotics or prebiotics

SCFA: Short-chain fatty acid.