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The microbiome, cancer, and cancer therapy

Nature Medicinevolume 25pages377388 (2019) | Download Citation

Abstract

With the advent of next-generation sequencing, we have an unprecedented ability to study tumor and host genomes as well as those of the vast array of microorganisms that exist within living organisms. Evidence now suggests that these microbes may confer susceptibility to certain cancers and may also influence response to therapeutics. A prime example of this is seen with immunotherapy, for which gut microbes have been implicated in influencing therapeutic responses in preclinical models and patient cohorts. However, these microbes may influence responses to other forms of therapy as well and may also affect treatment-associated toxicity. Based on these influences, there is growing interest in targeting these microbes in the treatment of cancer and other diseases. Yet complexities exist, and a deeper understanding of host–microbiome interactions is critical to realization of the full potential of such approaches. These concepts and the means through which such findings may be translated into the clinic will be discussed herein.

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Author notes

  1. These authors jointly directed this work: Vancheswaran Gopalakrishnan, Jennifer A. Wargo.

Affiliations

  1. Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA

    • Beth A. Helmink
    • , M. A. Wadud Khan
    • , Amanda Hermann
    • , Vancheswaran Gopalakrishnan
    •  & Jennifer A. Wargo
  2. Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA

    • Jennifer A. Wargo

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Competing interests

J.A.W. and V.G. are inventors on a US patent application (PCT/US17/53,717), submitted by The University of Texas MD Anderson Cancer Center, that covers methods to enhance checkpoint blockade therapy by the microbiome. J.A.W. reports compensation for speaker’s bureau and honoraria from Imedex, Dava Oncology, Omniprex, Illumina, Gilead, MedImmune and Bristol-Myers Squibb. J.A.W. serves as a consultant / advisory board member for Roche/Genentech, Novartis, AstraZeneca, GlaxoSmithKline, Bristol-Myers Squibb, Merck, Biothera Pharmaceuticals and Microbiome DX. J.A.W. also receives research support from GlaxoSmithKline, Roche/Genentech, Bristol-Myers Squibb, and Novartis. A.C-H. and M.A.W.K. report no relevant conflicts of interest or financial disclosures. B.A.H. is supported by National Institutes of Health T32 CA 009599 and the MD Anderson Cancer Center support grant P30 CA016672.

Corresponding author

Correspondence to Jennifer A. Wargo.

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https://doi.org/10.1038/s41591-019-0377-7