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ESMO 2025 | Gut and oral microbiomes linked to chemotherapy outcomes in GI cancer
David Goldstein, MBBS, FRACP, PRCP, University of New South Wales, Sydney, Australia, discusses findings from an Australian study examining how gut and oral microbiomes influence chemotherapy outcomes in patients with gastrointestinal cancers. The study found that chemotherapy altered microbial composition, with both gut and oral microbiomes shifting toward healthier profiles post-treatment. Notably, baseline gut microbial diversity was associated with survival outcomes, suggesting that broader microbiome structure may influence treatment response. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
The influence of the microbiome in immunotherapy is really well recognized. What’s less well known is what happens when patients have chemotherapy on their microbiome. So that’s the question we asked in a cross-sectional way, so only a beginning, not a definitive. But what we did show is the good news. Yes, we totally disrupt the microbiome with chemotherapy, but it does recover...
The influence of the microbiome in immunotherapy is really well recognized. What’s less well known is what happens when patients have chemotherapy on their microbiome. So that’s the question we asked in a cross-sectional way, so only a beginning, not a definitive. But what we did show is the good news. Yes, we totally disrupt the microbiome with chemotherapy, but it does recover. So that’s the good news. The more difficult news is that depending on what we disrupt and depending on the cancer’s effect on the microbiome, you may start with patients who are going to do very badly with that disrupted microbiome. And so we got a hint of that as well. And that’s really probably where we will devote our subsequent efforts.
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