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Perspective on the Role of Gut Microbiome in the Treatment of Hepatocellular Carcinoma with Immune Checkpoint Inhibitors.
Abenavoli, Ludovico; Montori, Michele; Svegliati Baroni, Gianluca; Argenziano, Maria Eva; Giorgi, Francesca; Scarlata, Giuseppe Guido Maria; Ponziani, Francesca; Scarpellini, Emidio.
  • Abenavoli L; Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy.
  • Montori M; Clinic of Gastroenterology and Hepatology, Emergency Digestive Endoscopy, Polytechnics University of Marche, 60126 Ancona, Italy.
  • Svegliati Baroni G; "Transplant and Hepatic Damage" Unit, Polytechnics University of Marche, 60126 Ancona, Italy.
  • Argenziano ME; Clinic of Gastroenterology and Hepatology, Emergency Digestive Endoscopy, Polytechnics University of Marche, 60126 Ancona, Italy.
  • Giorgi F; Oncology Unit, "Madonna del Soccorso" General Hospital, 63074 San Benedetto del Tronto, Italy.
  • Scarlata GGM; Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy.
  • Ponziani F; Digestive Disease Center (C.E.M.A.D.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
  • Scarpellini E; Translational Medicine and Surgery Department, Catholic University of the Sacred Heart, 00168 Rome, Italy.
Medicina (Kaunas) ; 59(8)2023 Aug 06.
Article en En | MEDLINE | ID: mdl-37629716
ABSTRACT
Background and

Objectives:

Hepatocellular carcinoma (HCC) is the leading cause of liver cancer worldwide and has a high mortality rate. Its incidence has increased due to metabolic-associated liver disease (MAFLD) epidemics. Liver transplantation and surgery remain the most resolute measures. Despite the optimistic use of multi-kinase inhibitors, namely sorafenib, the co-existence of chronic liver disease made the response rate low in these patients. Immune checkpoint inhibitors (ICIs) have become a promising hope for certain advanced solid tumors and, also, for advanced HCC. Unfortunately, a large cohort of patients with HCC fail to respond to immunotherapy. Materials and

Methods:

We conducted a narrative search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials, and case series using the following keywords and acronyms and their associations hepatocellular carcinoma, immunotherapy, checkpoint inhibitors, gut microbiota, and fecal microbiota transplantation.

Results:

ICIs are a promising and sufficiently safe treatment option for HCC. In detail, they have significantly improved survival and prognosis in these patients vs. sorafenib. Although there are several highlighted mechanisms of resistance, the gut microbiota signature can be used both as a response biomarker and as an effect enhancer. Practically, probiotic dose-finding and fecal microbiota transplantation are the weapons that can be used to increase ICI's treatment-response-reducing resistance mechanisms.

Conclusion:

Immunotherapy has been a significant step-up in HCC treatment, and gut microbiota modulation is an effective liaison to increase its efficacy.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Microbioma Gastrointestinal / Neoplasias Hepáticas Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Humans Idioma: En Año: 2023 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Microbioma Gastrointestinal / Neoplasias Hepáticas Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Humans Idioma: En Año: 2023 Tipo del documento: Article