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ESTRO 2026 | Gut microbiome may predict immunotherapy and radiotherapy toxicity

Miguel Reis Ferreira, FRCR, MD, PhD, Guys and St Thomas NHS Foundation Trust, London, UK, discusses the potential impact of the gut microbiome on immunotherapy and radiation-induced toxicity, highlighting a study that found associations between the gut microbiome and radiation-induced toxicity. Novel methods are now being assessed to translate these findings into applications, including modifying the microbiome to reduce side effects and predicting side effects to adapt radiotherapy to individual patients. This interview took place at the European Society for Radiotherapy and Oncology 2026 Congress in Stockholm, Sweden.

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Transcript

It’s a very broad question and difficult to answer. So the gut microbiome has been, let’s call it, under the attention of oncologists since the studies that showed that it impacted immunotherapy. And I carried out a study that was published in 2019 that showed associations between the gut microbiome and radiation-induced toxicity. So we’re taking that forward now to translate that into applications...

It’s a very broad question and difficult to answer. So the gut microbiome has been, let’s call it, under the attention of oncologists since the studies that showed that it impacted immunotherapy. And I carried out a study that was published in 2019 that showed associations between the gut microbiome and radiation-induced toxicity. So we’re taking that forward now to translate that into applications. So one of the applications is if you change the microbiome, whether it actually reduces those side effects. So we found that short-chain fatty acid-producing bacteria were somewhat reduced during treatment in patients that had side effects so we’re going to try to change that and the other thing is actually to predict the side effects a bit better so that you can change the radiotherapy and adapt it to patients.

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