Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma

Treatment options for metastatic pancreatic ductal adenocarcinoma (mPDAC) patients remain limited, meaning that death within weeks of diagnosis unfortunately remains a common occurrence. Whilst metastases from other malignancy sites, such as colorectal and breast, are amenable to resection in select...

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Main Authors: James M. Halle-Smith, Lewis A. Hall, Sarah F. Powell-Brett, Nabeel Merali, Adam Frampton, Keith J. Roberts
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Clinical Surgical Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773160X23000120
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author James M. Halle-Smith
Lewis A. Hall
Sarah F. Powell-Brett
Nabeel Merali
Adam Frampton
Keith J. Roberts
author_facet James M. Halle-Smith
Lewis A. Hall
Sarah F. Powell-Brett
Nabeel Merali
Adam Frampton
Keith J. Roberts
author_sort James M. Halle-Smith
collection DOAJ
description Treatment options for metastatic pancreatic ductal adenocarcinoma (mPDAC) patients remain limited, meaning that death within weeks of diagnosis unfortunately remains a common occurrence. Whilst metastases from other malignancy sites, such as colorectal and breast, are amenable to resection in selected patients, consensus remains largely against resection of mPDAC. Without surgical resection, chemotherapy remains the main treatment option and despite advances in regimens, a large proportion of mPDAC patients do not respond to these treatments. Understandably, investigation into whether different genetic subtypes of PDAC can explain the changes in response to chemotherapy have been carried out but as yet has not demonstrated any marked differences between those that do and do not respond to chemotherapy treatment.This review outlines the emerging role that both the gut and tumour microbiome play in modulating the progression of PDAC, ranging from chemosensitivity to immune infiltration of the tumour This puts the gut microbiome in a promising position as a potential future therapeutic route for mPDAC patients. Possible methods to modulate the gut and tumour microbiome include antibiotics, probiotics and faecal microbiota transplantation (FMT). The next steps should therefore be to focus upon how we can effectively and safely introduce these beneficial bacteria into the gut and tumour microbiome of mPDAC patients through clinical trials.
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spelling doaj-art-bf8dbe178f2c4e8ab35a9ead5250df502024-11-22T07:40:08ZengElsevierClinical Surgical Oncology2773-160X2023-12-0124100020Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinomaJames M. Halle-Smith0Lewis A. Hall1Sarah F. Powell-Brett2Nabeel Merali3Adam Frampton4Keith J. Roberts5Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Corresponding author. James M Halle-Smith Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; College of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomHepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; College of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomSection of Oncology, Dept. of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, United Kingdom; Minimal Access Therapy Training Unit (MATTU), Leggett Building, University of Surrey, Guildford, Surrey, United Kingdom; Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, United KingdomSection of Oncology, Dept. of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, United Kingdom; Minimal Access Therapy Training Unit (MATTU), Leggett Building, University of Surrey, Guildford, Surrey, United Kingdom; Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, United KingdomHepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; College of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomTreatment options for metastatic pancreatic ductal adenocarcinoma (mPDAC) patients remain limited, meaning that death within weeks of diagnosis unfortunately remains a common occurrence. Whilst metastases from other malignancy sites, such as colorectal and breast, are amenable to resection in selected patients, consensus remains largely against resection of mPDAC. Without surgical resection, chemotherapy remains the main treatment option and despite advances in regimens, a large proportion of mPDAC patients do not respond to these treatments. Understandably, investigation into whether different genetic subtypes of PDAC can explain the changes in response to chemotherapy have been carried out but as yet has not demonstrated any marked differences between those that do and do not respond to chemotherapy treatment.This review outlines the emerging role that both the gut and tumour microbiome play in modulating the progression of PDAC, ranging from chemosensitivity to immune infiltration of the tumour This puts the gut microbiome in a promising position as a potential future therapeutic route for mPDAC patients. Possible methods to modulate the gut and tumour microbiome include antibiotics, probiotics and faecal microbiota transplantation (FMT). The next steps should therefore be to focus upon how we can effectively and safely introduce these beneficial bacteria into the gut and tumour microbiome of mPDAC patients through clinical trials.http://www.sciencedirect.com/science/article/pii/S2773160X23000120Pancreatic ductal adenocarcinomaMetastasesGut microbiomeTumour microbiome
spellingShingle James M. Halle-Smith
Lewis A. Hall
Sarah F. Powell-Brett
Nabeel Merali
Adam Frampton
Keith J. Roberts
Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
Clinical Surgical Oncology
Pancreatic ductal adenocarcinoma
Metastases
Gut microbiome
Tumour microbiome
title Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
title_full Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
title_fullStr Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
title_full_unstemmed Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
title_short Realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
title_sort realising the therapeutic potential of the human microbiota in metastatic pancreatic ductal adenocarcinoma
topic Pancreatic ductal adenocarcinoma
Metastases
Gut microbiome
Tumour microbiome
url http://www.sciencedirect.com/science/article/pii/S2773160X23000120
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