Can Consideration of the Microbiome Improve Antimicrobial Utilization and Treatment Outcomes in the Oncology Patient?
Can Consideration of the Microbiome Improve Antimicrobial Utilization and Treatment Outcomes in the Oncology Patient?
复制标题
DOI：
10.1158/1078-0432.ccr-16-3173
复制
发表时间：
2017-07-01
期刊：
影响因子：
--
通讯作者：
Shelburne SA
中科院分区：
文献类型：
--
作者：
Galloway-Peña JR;Jenq RR;Shelburne SA
为感染的癌症患者提供有效和及时的抗微生物治疗的需要是公认的，但由于初步但不断积累的证据表明，抗生素诱导的微生物组生态失调影响癌症治疗反应，非感染性毒性和感染性并发症而有所缓和。鉴于只有少数经验性治疗的癌症患者被证明患有真正的细菌感染，重要的是要考虑广泛使用广谱抗菌剂对肠道微生物群的潜在负面影响。在此，我们回顾了文献，证实了肿瘤学家在治疗疑似或记录的感染时面临的困境，这些感染与宿主微生物组，抗生素和癌症相关临床结果之间的相互作用有关。我们提出了基于微生物组的探索，可以帮助肿瘤学家优化癌症相关感染以及癌症本身的治疗策略。此外，我们还讨论了这个新生领域的知识差距和挑战，必须加以解决，以提供医学相关的翻译应用。我们预计，关于微生物群在癌症患者健康中的作用的新知识可能会导致重新评估抗生素在肿瘤学环境中的使用方式以及肿瘤学家如何看待微生物。
The need to provide effective and timely antimicrobial treatment to cancer patients with infections is well-recognized, but tempered by preliminary, but accumulating, evidence that antibiotic-induced microbiome dysbiosis affects cancer therapy response, non-infectious toxicities, and infectious complications. Given only a minority of empirically treated cancer patients are proven to have a true bacterial infection, it is important to consider the potential negative consequences of extensive broad-spectrum antimicrobial use on the commensal microbiota. Herein, we review the literature substantiating the dilemma oncologists face when treating suspected or documented infections with respect to the interaction between the host microbiome, antibiotics, and cancer-related clinical outcomes. We propose microbiome-based explorations that could assist oncologists in optimizing treatment strategies for cancer-related infections as well as the cancer, itself. In addition, we discuss knowledge gaps and challenges in this nascent field that must be addressed in order to deliver medically relevant translational applications. We anticipate the emerging knowledge regarding the role of the microbiota in the health of cancer patients may cause a reappraisal of the manner in which antibiotics are used in the oncologic setting and how microorganisms are viewed by oncologists.