Microbiome Modulation for the Treatment of Solid Neoplasms.

Preclinical studies have identified specific bacterial species linked to improved responses to immune checkpoint inhibitors (ICIs), leading to clinical investigations in melanoma, renal cell carcinoma (RCC), and non-small cell lung cancer (NSCLC).

临床前研究已经确定了与免疫检查点抑制剂（ICIs）改善反应相关的特定细菌种类，这导致了在黑色素瘤、肾细胞癌（RCC）和非小细胞肺癌（NSCLC）中的临床调查。

The stool bacterial abundance of Ruminococcaceae, Akkermansia, and Bifidobacterium correlates with favorable clinical outcomes, whereas the disruption of the gut microbiome through antibiotics before or during ICI initiation is associated with higher rates of primary resistance and shorter survival. Biomarkers such as TOPOSCORE have been developed to better predict ICI benefits and estimate dysbiosis and treatment responses.

瘤胃球菌科、阿克曼氏菌和双歧杆菌的粪便细菌丰度与良好的临床结果相关，而通过抗生素在ICI启动前或期间破坏肠道微生物群与较高的原发性耐药率和较短的生存期相关。已经开发出如TOPOSCORE这样的生物标志物，以更好地预测ICI的益处并估计菌群失调和治疗反应。

Several microbiome-modulating strategies have shown potential in patients receiving treatment with ICIs-for instance, high dietary fiber intake may be linked to improved outcomes.

例如，高膳食纤维摄入可能与改善结果相关。

As a separate strategy, certain probiotics appear to enhance clinical activity in early trials when incorporated into ICI-based regimens.

作为一种独立的策略，某些益生菌在纳入基于免疫检查点抑制剂（ICI）的方案中时，在早期试验中似乎增强了临床活性。

Finally, fecal microbiota transplantation has shown safety and efficacy in ICI-refractory melanoma and yielded encouraging results in treatment-naïve patients with melanoma, NSCLC, and RCC.

最后，粪便微生物群移植在免疫检查点抑制剂（ICI）耐药的黑色素瘤中显示出了安全性和有效性，并在治疗未经验的黑色素瘤、非小细胞肺癌（NSCLC）和肾细胞癌（RCC）患者中取得了令人鼓舞的结果。

Although several compelling signals have been observed to date with microbiome manipulation, the field is lacking large, definitive randomized trials-these are indeed a prerequisite for any of the highlighted strategies to become a standard of care.

尽管目前微生物组操纵已经观察到一些引人注目的信号，但该领域缺乏大型、明确的随机试验——这些试验确实是任何突出策略成为标准治疗的前提条件。