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...

Full description

Saved in:
Bibliographic Details
Main Authors: Anqi Lin, Lihaoyun Huang, Aimin Jiang, Lingxuan Zhu, Weiming Mou, Yu Li, Chunyan Zhang, Zaoqu Liu, Jian Zhang, Quan Cheng, Ting Wei, Peng Luo
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12916-025-04183-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849335683118792704
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
record_format Article
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
work_keys_str_mv AT anqilin microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT lihaoyunhuang microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT aiminjiang microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT lingxuanzhu microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT weimingmou microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT yuli microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT chunyanzhang microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT zaoquliu microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT jianzhang microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT quancheng microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT tingwei microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors
AT pengluo microbiotaboostimmunotherapyametaanalysisdivesintofecalmicrobiotatransplantationandimmunecheckpointinhibitors