Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors
Abstract Background Immune checkpoint inhibitors (ICIs) are a cornerstone of modern cancer treatment, but their effectiveness is limited. Fecal microbiota transplantation (FMT), which alters the gut microbiome, has shown promise in enhancing ICIs’ therapeutic effects. Methods We conducted a comprehe...
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2025-06-01
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| Online Access: | https://doi.org/10.1186/s12916-025-04183-y |
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| author | Anqi Lin Lihaoyun Huang Aimin Jiang Lingxuan Zhu Weiming Mou Yu Li Chunyan Zhang Zaoqu Liu Jian Zhang Quan Cheng Ting Wei Peng Luo |
| author_facet | Anqi Lin Lihaoyun Huang Aimin Jiang Lingxuan Zhu Weiming Mou Yu Li Chunyan Zhang Zaoqu Liu Jian Zhang Quan Cheng Ting Wei Peng Luo |
| author_sort | Anqi Lin |
| collection | DOAJ |
| description | Abstract Background Immune checkpoint inhibitors (ICIs) are a cornerstone of modern cancer treatment, but their effectiveness is limited. Fecal microbiota transplantation (FMT), which alters the gut microbiome, has shown promise in enhancing ICIs’ therapeutic effects. Methods We conducted a comprehensive search of relevant studies available up to September 30, 2024, to analyze the clinical efficacy and safety of combining FMT with ICIs in cancer treatment. The primary endpoint was the objective response rate (ORR), with secondary evaluations of survival outcomes and safety. Results A total of 10 studies involving 164 patients with solid tumors were included. The pooled ORR was 43% (95% CI: 0.35–0.51). Subgroup analysis revealed that the combination of anti-PD-1 and anti-CTLA-4 therapies was associated with a significantly higher ORR (60%) compared to anti-PD-1 monotherapy (37%; P = 0.01). The incidence of grade 1–2 adverse events (AEs) was 42% (95% CI: 0.32–0.52), while grade 3–4 AEs occurred in 37% of patients (95% CI: 0.28–0.46). Conclusions This meta-analysis provides preliminary evidence supporting the use of FMT as a strategy to enhance the efficacy of ICIs in patients with advanced or refractory solid tumors. However, larger-scale randomized controlled trials with long-term follow-up are required to confirm and optimize treatment protocols. |
| format | Article |
| id | doaj-art-6bb55b1a2b324af09a41a3f39e5983f8 |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | BMC Medicine |
| spelling | doaj-art-6bb55b1a2b324af09a41a3f39e5983f82025-08-20T03:45:11ZengBMCBMC Medicine1741-70152025-06-0123111510.1186/s12916-025-04183-yMicrobiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitorsAnqi Lin0Lihaoyun Huang1Aimin Jiang2Lingxuan Zhu3Weiming Mou4Yu Li5Chunyan Zhang6Zaoqu Liu7Jian Zhang8Quan Cheng9Ting Wei10Peng Luo11Donghai County People’s Hospital (Affiliated Kangda College of Nanjing Medical University); Department of Oncology, Zhujiang Hospital, Southern Medical UniversityDepartment of Oncology, Zhujiang Hospital, Southern Medical UniversityDepartment of Urology, Changhai Hospital, Naval Medical University (Second Military Medical University)Department of Oncology, Zhujiang Hospital, Southern Medical UniversityDepartment of Oncology, Zhujiang Hospital, Southern Medical UniversityDepartment of Oncology, Zhujiang Hospital, Southern Medical UniversityDepartment of Oncology, Zhujiang Hospital, Southern Medical UniversityInstitute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Oncology, Zhujiang Hospital, Southern Medical UniversityDepartment of Neurosurgery, Xiangya Hospital, Central South UniversityDepartment of Oncology, Zhujiang Hospital, Southern Medical UniversityDonghai County People’s Hospital (Affiliated Kangda College of Nanjing Medical University); Department of Oncology, Zhujiang Hospital, Southern Medical UniversityAbstract Background Immune checkpoint inhibitors (ICIs) are a cornerstone of modern cancer treatment, but their effectiveness is limited. Fecal microbiota transplantation (FMT), which alters the gut microbiome, has shown promise in enhancing ICIs’ therapeutic effects. Methods We conducted a comprehensive search of relevant studies available up to September 30, 2024, to analyze the clinical efficacy and safety of combining FMT with ICIs in cancer treatment. The primary endpoint was the objective response rate (ORR), with secondary evaluations of survival outcomes and safety. Results A total of 10 studies involving 164 patients with solid tumors were included. The pooled ORR was 43% (95% CI: 0.35–0.51). Subgroup analysis revealed that the combination of anti-PD-1 and anti-CTLA-4 therapies was associated with a significantly higher ORR (60%) compared to anti-PD-1 monotherapy (37%; P = 0.01). The incidence of grade 1–2 adverse events (AEs) was 42% (95% CI: 0.32–0.52), while grade 3–4 AEs occurred in 37% of patients (95% CI: 0.28–0.46). Conclusions This meta-analysis provides preliminary evidence supporting the use of FMT as a strategy to enhance the efficacy of ICIs in patients with advanced or refractory solid tumors. However, larger-scale randomized controlled trials with long-term follow-up are required to confirm and optimize treatment protocols.https://doi.org/10.1186/s12916-025-04183-yFecal microbiota transplantationImmune checkpoint inhibitorsClinical efficacyObjective response rateAdverse events |
| spellingShingle | Anqi Lin Lihaoyun Huang Aimin Jiang Lingxuan Zhu Weiming Mou Yu Li Chunyan Zhang Zaoqu Liu Jian Zhang Quan Cheng Ting Wei Peng Luo Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors BMC Medicine Fecal microbiota transplantation Immune checkpoint inhibitors Clinical efficacy Objective response rate Adverse events |
| title | Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors |
| title_full | Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors |
| title_fullStr | Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors |
| title_full_unstemmed | Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors |
| title_short | Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors |
| title_sort | microbiota boost immunotherapy a meta analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors |
| topic | Fecal microbiota transplantation Immune checkpoint inhibitors Clinical efficacy Objective response rate Adverse events |
| url | https://doi.org/10.1186/s12916-025-04183-y |
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