The Clinical Link between Human Intestinal Microbiota and Systemic Cancer Therapy

Romy Aarnoutse*, Janine Ziemons, John Penders, Sander S. Rensen, Judith de Vos-Geelen, Marjolein L. Smidt

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

31 Citations (Web of Science)


Clinical interest in the human intestinal microbiota has increased considerably. However, an overview of clinical studies investigating the link between the human intestinal microbiota and systemic cancer therapy is lacking. This systematic review summarizes all clinical studies describing the association between baseline intestinal microbiota and systemic cancer therapy outcome as well as therapy-related changes in intestinal microbiota composition. A systematic literature search was performed and provided 23 articles. There were strong indications for a close association between the intestinal microbiota and outcome of immunotherapy. Furthermore, the development of chemotherapy-induced infectious complications seemed to be associated with the baseline microbiota profile. Both chemotherapy and immunotherapy induced drastic changes in gut microbiota composition with possible consequences for treatment efficacy. Evidence in the field of hormonal therapy was very limited. Large heterogeneity concerning study design, study population, and methods used for analysis limited comparability and generalization of results. For the future, longitudinal studies investigating the predictive ability of baseline intestinal microbiota concerning treatment outcome and complications as well as the potential use of microbiota-modulating strategies in cancer patients are required. More knowledge in this field is likely to be of clinical benefit since modulation of the microbiota might support cancer therapy in the future.

Original languageEnglish
Article number4145
Number of pages34
JournalInternational journal of molecular sciences
Issue number17
Publication statusPublished - 1 Sep 2019


  • human intestinal microbiota
  • systemic cancer therapy
  • chemotherapy
  • immunotherapy
  • hormonal therapy
  • clinical relevance
  • baseline microbiota sampling
  • longitudinal microbiota sampling
  • 16S rRNA gene sequencing
  • metagenomic sequencing
  • RISK

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