Published online Jul 7, 2023. doi: 10.3748/wjg.v29.i25.3984
Peer-review started: May 15, 2023
First decision: May 23, 2023
Revised: May 24, 2023
Accepted: June 12, 2023
Article in press: June 12, 2023
Published online: July 7, 2023
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.
Core Tip: Pancreatic cancer (PC) remains of on the most dismal in terms of prognosis. Treatment options are limited and even after complete surgical resection, the prognosis remains poor. The gut microbiome has been incriminated in the past for the development of certain cancers. Our review found that observation to be true as well for PC. Furthermore, we also found that it plays a role in efficacy and tolerance of certain regimens used to treat PC.