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Review | Open Access

The role of intestinal flora on tumorigenesis, progression, and the efficacy of PD-1/PD-L1 antibodies in colorectal cancer

Sen Wang1,*, Benling Xu2,*, Yangyang Zhang1, Guangyu Chen2, Peng Zhao1, Quanli Gao2 ( ), Long Yuan1 ( )
Department of Gastrointestinal Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003, China
Department of Immunotherapy, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003, China

*These authors contributed equally to this work.

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Abstract

Intestinal flora affects the maturation of the host immune system, serves as a biomarker and efficacy predictor in the immunotherapy of several cancers, and has an important role in the development of colorectal cancer (CRC). Anti-PD-1/PD-L1 antibodies have shown satisfactory results in MSI-H/dMMR CRC but performed poorly in patients with MSS/pMMR CRC. In recent years an increasing number of studies have shown that intestinal flora has an important impact on anti-PD-1/PD-L1 antibody efficacy in CRC patients. Preclinical and clinical evidence have suggested that anti-PD-1/PD-L1 antibody efficacy can be improved by altering the composition of the intestinal flora in CRC. Herein, we summarize the studies related to the influence of intestinal flora on anti-PD-1/PD-L1 antibody efficacy in CRC and discuss the potential underlying mechanism(s). We have focused on the impact of the intestinal flora on the efficacy and safety of anti-PD-1/PD-L1 antibodies in CRC and how to better utilize the intestinal flora as an adjuvant to improve the efficacy of anti-PD-1/PD-L1 antibodies. In addition, we have provided a basis for the potential of the intestinal flora as a new treatment modality and indicator for determining patient prognosis.

Keywords

colorectal cancerimmune checkpoint inhibitorIntestinal floraanti-PD-1/PD-L1 therapyCD8+ T cell

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Cancer Biology & Medicine
Volume 21 Issue 1,
January 2024
Pages 65-82
DOI: 10.20892/j.issn.2095-3941.2023.0376
Cite this article:
Wang S, Xu B, Zhang Y, et al. The role of intestinal flora on tumorigenesis, progression, and the efficacy of PD-1/PD-L1 antibodies in colorectal cancer. Cancer Biology & Medicine, 2024, 21(1): 65-82. https://doi.org/10.20892/j.issn.2095-3941.2023.0376

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Received: 24 September 2023
Accepted: 24 November 2023
Published: 23 December 2023
©2024 Cancer Biology & Medicine.

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