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

Table 4 Microbiome-targeted treatment strategies in hepatobiliary cancers

Topic	Findings	Key insights
Antibiotics, probiotics, and GBC	Limited experimental and clinical evidence on their use for GBC prevention or treatment[255]	Salmonella infection may trigger lasting oncogenic changes
	A study by Scanu et al[255] found that Salmonella-infected mouse embryonic fibroblasts formed tumors even after bacterial eradication with ciprofloxacin
	Salmonella infection activates Akt/MAPK signaling pathways, potentially sustaining carcinogenesis post-eradication[255]	Further research is needed to explore microbiome-targeted GBC therapies
	Cholecystectomy remains the most effective preventive measure for chronic typhoid carriers at risk of GBC[251]
Probiotics and HCC prevention	Probiotic-fermented milk and chlorophyllin reduced tumor incidence in AFB1-induced HCC in rats[276]	Probiotics show potential in reducing HCC risk and progression in animal models
	VSL3 probiotic formula inhibited chemically induced HCC, reducing LPS levels, tumor size, and tumor count[267]
	Prohep (novel probiotic mix) decreased tumor growth by 40%, enhanced anti-inflammatory responses, promoted T-cell activation, and reduced pro-angiogenic factors in mice[277]	Clinical evidence remains limited, requiring large-scale human trials
Probiotics and aflatoxin exposure	Some studies suggest probiotics reduce aflatoxin exposure and toxic DNA adduct formation, potentially lowering HCC risk[278]	Needs further validation in human studies
FMT and liver disease	FMT has shown promise in treating[279]: (1) High-fat diet and alcohol-induced liver injury (animal models)[280]; (2) Severe alcoholic hepatitis (clinical studies)[281]; (3) Chronic hepatitis B[282]; and (4) Advanced liver cirrhosis and hepatic encephalopathy	FMT may help restore gut-liver axis balance[279]
		Its role in HCC prevention and therapy remains unclear, requiring further clinical trials

GBC: Gallbladder cancer; Akt: Protein kinase B; MAPK: Mitogen-activated protein kinase; HCC: Hepatocellular carcinoma; AFB1: Aflatoxin B1; LPS: Lipopolysaccharide; FMT: Fecal microbiome transplantation.