Gut microbiome and nutritional strategies in gastrointestinal cancers: Clinical implications and therapeutic perspectives

Table 3 Microbiome-targeted treatment strategies in gastroesophageal cancer

Topic	Findings	Key insights
Microbiomes in esophageal cancer treatment	Disrupting microbiome with antibiotics decreases xenograft tumor response to CpG oligonucleotide immunotherapy and platinum-based chemotherapy (e.g., oxaliplatin)[180]	A stable commensal microbiome may enhance cancer therapy effectiveness[180]
	Similar effects observed in germ-free mice[180,234]	Microbiome regulates myeloid-derived cell functions within the tumor microenvironment[234]
		Further clinical research is needed
H. pylori and GC risk	H. pylori eradication reduces GC risk but does not guarantee complete prevention[235,236]	Other factors contribute to GC beyond H. pylori infection[235]
	A Colombian clinical trial showed no significant GC incidence difference between treated and untreated individuals over six years, but treated individuals had higher precancerous lesion regression rates[235]	Eradication reduces GC risk by about 44% in asymptomatic, infected individuals[236]
Long-term impact of H. pylori eradication	A 15-year study showed a 39% reduction in precancerous lesions[237]	Protective effects are strongest in non-atrophic/atrophic gastritis patients[239,240]
	An 8-year study found that atrophic body gastritis reversed in 50% of treated patients[238]	Intestinal metaplasia and dysplasia patients do not experience the same benefit
	Meta-analyses confirmed a significant reduction in GC risk post-eradication[239]	Early eradication is crucial as intestinal metaplasia is irreversible
Epigenetic modifications in GC prevention	DNA demethylating agent (5-azadC) suppresses aberrant methylation and reduces GC incidence in animal models[241]	Developing safer DNA demethylating agents could benefit high-risk individuals[223]
	Clinical use is limited due to high toxicity
Probiotics and H. pylori eradication	Probiotics inhibit H. pylori in animal studies[242]	Probiotics may play a role in GC prevention[243,244]
	Clinical trials/meta-analyses show probiotics improve eradication rates, patient compliance, and reduce treatment side effects	Used alongside antibiotics, they enhance treatment efficacy

H. pylori: Helicobacter pylori; CpG: Cytosine-phosphate-guanine; GC: Gastric cancer.