4.7 Review

The efficacy and toxicity of antineoplastic antimetabolites: Role of gut microbiota

Journal

TOXICOLOGY
Volume 460, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.tox.2021.152858

Keywords

Antineoplastic antimetabolites; Cancer; Individualized medication; Gut microbiota; Probiotics

Funding

  1. National Development of Key Novel Drugs for Special Projects of China [2017ZX09304014]
  2. Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples [2017TP1037]
  3. Key R&D Programs of Hunan Province [2019SK2241]
  4. Innovation and Entrepreneurship Investment Project in Hunan Province [2019GK5020]
  5. International Scientific and Technological Innovation Cooperation Base for Bioanalysis of Complex Matrix Samples in Hunan Province [2019CB1014]
  6. Science and technology project of Changsha [kh1902002]
  7. Hunan Science and technology innovation plan project [2018SK52008]
  8. National Natural Science Foundation of China [81803837]
  9. Natural Science Foundation of Hunan Province [2019JJ50839]

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The review discusses the interaction between antineoplastic antimetabolites and gut microbiota, exploring the effects of shifted gut microbiota profiles on the efficacy and toxicity of these medications. Factors affecting the efficacy and toxicity of antineoplastic antimetabolites via gut microbiota are also discussed, along with the potential benefits of regulating gut microbiota to improve treatment outcomes.
The incidence and mortality of cancer are rapidly growing all over the world. Nowadays, antineoplastic antimetabolites still play a key role in the chemotherapy of cancer. However, the interindividual variations in the efficacy and toxicity of antineoplastic antimetabolites are nonnegligible challenges to their clinical applications. Although many studies have focused on genetic variation, the reasons for these interindividual variations have still not been fully understood. Gut microbiota is reported to be associated with the efficacy and toxicity of antineoplastic antimetabolites. In this review, we summarize the interaction of antineoplastic antimetabolites on gut microbiota and the influences of shifted gut microbiota profiles on the efficacy and toxicity of antineoplastic antimetabolites. The factors affecting the efficacy and toxicity of antineoplastic antimetabolites via gut microbiota are also discussed. In addition, we present our viewpoints that regulating the gut microbiota may increase the efficacy and decrease the toxicity of antineoplastic antimetabolites. This will help us better understand the new mechanism via gut microbiota and promote individualized use of antineoplastic antimetabolites.

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