Microbiota in cancer care: Clinical prospects.
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BACKGROUND: Probiotics and microbial metabolites exhibit dual roles in cancer biology, serving as both therapeutic agents and biomarkers. Lactobacillus species inhibit pathogen-driven tumorigenesis and predict immunotherapy efficacy, yet their depletion correlates with polycystic ovary syndrome (PCOS) and gastrointestinal cancers. Conversely, expansion of specific strains, such as L. plantarum 299 v, enhances iron absorption and mitigates mucositis. Similarly, Bifidobacterium modulates gut microbiota (GM) toward tumor suppression in colorectal cancer (CRC) and improves pediatric outcomes, though paradoxically rising in refractory multiple myeloma. Short-chain fatty acids (SCFAs) acetate, propionate, and butyrate protect against CRC via anti-inflammatory and epigenetic mechanisms, while Akkermansia muciniphila enhances immunotherapy responses in CRC and NSCLC through GM-tumor microenvironment crosstalk. OBJECTIVE: This mini review aimed to decipher the prospects of macromolecules in their role as anti cancer based on human clinical trials. INTERVENTIONS: Interventions include multi-strain probiotics, synbiotics, and dietary strategies (Mediterranean diets, fermented foods) that restore GM balance and boost SCFA production. LIMITATIONS: Limitations persist on strain-specific variability, biomarker ambiguity, and inconsistent efficacy of probiotics in radiotherapy-induced diarrhea. RECOMMENDATION: To address these, precision medicine approaches prioritizing strain-specific formulations, validated biomarkers, and combination therapies are advocated. Personalized nutrition and clinical tools further optimize outcomes. CONCLUSION: Future research must clarify Akkermansia-TMAO interactions, SCFA epigenetic dynamics, and combinatorial regimens to harness microbiota-host crosstalk. By integrating advanced analytics and population-tailored strategies, microbiota-targeted interventions hold transformative potential in cancer prevention, therapy, and diagnostics.