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Role of the Microbiome in the Diagnosis and Management of Gastroesophageal Cancers

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Abstract

Purpose

Stomach and esophageal cancers are among the highest mortality from cancers worldwide. Microbiota has an interplaying role within the human gastrointestinal (GI) tract. Dysbiosis occurs when a disruption of the balance between the microbiota and the host happens. With this narrative review, we discuss the main alterations in the microbiome of gastroesophageal cancer, revealing its potential role in the pathogenesis, early detection, and treatment.

Results

Helicobacter pylori plays a major role the development of a cascade of preneoplastic conditions ranging from atrophic gastritis to metaplasia and dysplasia, ultimately culminating in gastric cancer, while other pathogenic agents are Fusobacterium nucleatum, Bacteroides fragilis, Escherichia coli, and Lactobacillus. Campylobacter species (spp.)’s role in the progression of esophageal adenocarcinoma may parallel that of Helicobacter pylori in the context of gastric cancer, with other esophageal carcinogenic agents being Escherichia coli, Bacteroides fragilis, and Fusobacterium nucleatum. Moreover, gut microbiome could significantly alter the outcomes of chemotherapy and immunotherapy. The gut microbiome can be modulated through interventions such as antibiotics, probiotics, or prebiotics intake. Fecal microbiota transplantation has emerged as a therapeutic strategy as well.

Conclusions

Nowadays, it is widely accepted that changes in the normal gut microbiome causing dysbiosis and immune dysregulation play a role gastroesophageal cancer. Different interventions, including probiotics and prebiotics intake are being developed to improve therapeutic outcomes and mitigate toxicities associated with anticancer treatment. Further studies are required in order to introduce the microbiome among the available tools of precision medicine in the field of anticancer treatment.

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Data Availability

No datasets were generated or analyzed during the current study.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Federica Mascaretti and Salman Haider contributed equally to this work.

Authors and Affiliations

  1. Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Federica Mascaretti, Chiara Amoroso & Flavio Caprioli

  2. Department of Internal Medicine, Brooklyn Hospital Center, Brooklyn, New York, NY, USA

    Salman Haider

  3. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

    Flavio Caprioli

  4. Division of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT, USA

    Daryl Ramai

  5. Medical Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122, Via Sforza 28, Milan, Italy

    Michele Ghidini

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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Federica Mascaretti, Salman Haider, Chiara Amoroso, and Michele Ghidini. The first draft of the manuscript was written by Federica Mascaretti and Salman Haider, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Michele Ghidini.

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Mascaretti, F., Haider, S., Amoroso, C. et al. Role of the Microbiome in the Diagnosis and Management of Gastroesophageal Cancers. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01021-x

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