Role of the microbiota in response to and recovery from cancer therapy

Stephen J. Blake, Yochai Wolf, Ben Boursi, David J. Lynn*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Our understanding of how the microbiota affects the balance between response to and failure of cancer treatment by modulating the tumour microenvironment and systemic immune system has advanced rapidly in recent years. Microbiota-targeting interventions in patients with cancer are an area of intensive investigation. Promisingly, phase I–II clinical trials have shown that interventions such as faecal microbiota transplantation can overcome resistance to immune checkpoint blockade in patients with melanoma, improve therapeutic outcomes in treatment-naive patients and reduce therapy-induced immunotoxicities. Here, we synthesize the evidence showing that the microbiota is an important determinant of both cancer treatment efficacy and treatment-induced acute and long-term toxicity, and we discuss the complex and inter-related mechanisms involved. We also assess the potential of microbiota-targeting interventions, including bacterial engineering and phage therapy, to optimize the response to and recovery from cancer therapy.

Original languageEnglish
Pages (from-to)308-325
Number of pages18
JournalNature Reviews Immunology
Issue number5
StatePublished - May 2024


FundersFunder number
Australian Medical Research Future FundMRF2007441
Lemelbaum family
Leukaemia Foundation of Australia
Tour De Cure Pioneering Research GrantRSP-264–18/19
Melanoma Research Alliance937368
Melanoma Research Alliance
Rosetrees TrustMYIA\100002
Rosetrees Trust
National Health and Medical Research Council


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