Same Drug, Different Outcome

This illustration shows how differences in the gut microbiome may influence patients’ responses differently to the same anticancer drug. In patients with eubiosis, beneficial bacteria produce metabolites such as short-chain fatty acids (SCFAs) which help maintain the gut barrier integrity, reduce systemic inflammation, and enhance antitumor immunity through dendritic cell priming and CD8⁺ T-cell function. This creates an immune-responsive tumor environment, improving treatment effectiveness and promoting tumor shrinkage. In patients with dysbiosis, pathogenic microbes increase inflammatory signals like Lipopolysaccharides (LPS) which can activate TLR4-NF-κB signalling and drive chronic inflammation, immune dysfunction, and therapy resistance, allowing tumors to persist or grow despite therapy.