Authors
Darja Nikitina, Egidijus Morkunas, Povilas Sabanas, Paulius Jonaitis, Tadas Urbonas, Greta Gedgaudiene, Rolandas Gedgaudas, Kristina Kupcinskiene, Andrius Macas, Sarunas Simenas, Dovile Kiudelyte, Roberta Buginyte, Astra Vitkauskiene, Lina Poskiene, Francesco Strati, Jurgita Skieceviciene, Juozas Kupcinskas
Published in
Best practice & research. Clinical gastroenterology. Volume 83. Pages 102127. Epub Jul 27, 2026.
Abstract
The gastrointestinal microbiome has emerged as a critical interface between environmental exposures and host biology, shaping carcinogenesis, tumor behavior, and therapeutic responsiveness across digestive tract malignancies. This narrative review synthesizes current evidence on microbiome testing in esophageal, gastric, colorectal, hepatobiliary, pancreatic, and gastrointestinal stromal cancers, highlighting microbial signatures, emerging translational applications, and the methodological challenges that currently limit clinical implementation. Tumor-specific microbial alterations are considered alongside the broader functional consequences of dysbiosis, including its roles in genotoxicity, immune modulation, and metabolic reprogramming. Particular attention is given to the influence of the microbiome on systemic therapies, especially immune checkpoint inhibition, where microbial diversity, compositional signatures, and antibiotic exposure have been associated with differences in treatment efficacy. Emerging mechanistic insights are highlighted, including the role of microbiota-derived metabolites as key mediators of host-tumor immune interactions. The review further discusses microbiome-directed interventions, including fecal microbiota transplantation and dietary modulation, while critically evaluating the barriers to their clinical translation. Although microbiome profiling has considerable potential to improve risk stratification and therapeutic personalization, current evidence remains largely associative or based on early-phase clinical studies, and no microbiome-based testing strategy has yet been validated for routine clinical use beyond Helicobacter pylori eradication for gastric cancer prevention. Large prospective studies, standardized methodologies, and interventional clinical trials are required before microbiome testing can be integrated into routine precision oncology.
PMID:
42971661
Bibliographic data and abstract were imported from PubMed on 03 Nov 2026.
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