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<p>Prognosis for primary malignant brain tumors remains poor despite multimodal therapy, and emerging evidence implicates gut microbiota dysbiosis in treatment variability. We systematically reviewed human studies to assess the efficacy and safety of gut microbiota-modulating adjuvants to standard therapy and to appraise the diagnostic/prognostic utility of microbiome signatures in brain tumors. PubMed, ScienceDirect, SpringerLink, and Cochrane were searched (2015–2025) for human studies on brain tumors assessing gut microbiota modulation or microbiome-outcome associations. Seventeen studies published between 2021 and 2025 met the inclusion criteria. Evidence consistently demonstrated gut microbiome alterations in brain tumor patients, characterized by enrichment of <i>Proteobacteria</i> and <i>Escherichia–Shigella</i> and depletion of <i>Faecalibacterium</i>. Several studies reported diagnostic and prognostic potential, with microbiome-based models achieving high predictive accuracy (AUC 0.77–0.94). Increased <i>Veillonella</i> abundance correlated with longer overall survival, while combined microbiome and C-reactive protein (CRP) profiles accurately predicted radiotherapy response in metastatic cases. A perioperative probiotic trial improved postoperative bowel function without increasing adverse events. The gut microbiome is strongly associated with brain tumors and holds promise as a diagnostic and prognostic biomarker. However, direct evidence from interventional studies on the efficacy of microbiota modulation for improving survival remains scarce and inconclusive. Future large, prospective, and controlled interventional trials are urgently needed to establish causality and therapeutic utility.</p>

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Gut microbiota modulation as an adjuvant therapy to improve treatment response and survival in brain tumor patients: a systematic review

  • 期刊论文

  • 发表日期：

    2026年3月19日

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  • Farhad Balafif,
  • Donny Wisnu Wardhana,
  • Tommy Alfandy Nazwar,
  • Fachriy Balafif,
  • Christin Panjaitan,
  • Anisa Nur Kholipah,
  • Mustofa

摘要

Prognosis for primary malignant brain tumors remains poor despite multimodal therapy, and emerging evidence implicates gut microbiota dysbiosis in treatment variability. We systematically reviewed human studies to assess the efficacy and safety of gut microbiota-modulating adjuvants to standard therapy and to appraise the diagnostic/prognostic utility of microbiome signatures in brain tumors. PubMed, ScienceDirect, SpringerLink, and Cochrane were searched (2015–2025) for human studies on brain tumors assessing gut microbiota modulation or microbiome-outcome associations. Seventeen studies published between 2021 and 2025 met the inclusion criteria. Evidence consistently demonstrated gut microbiome alterations in brain tumor patients, characterized by enrichment of Proteobacteria and Escherichia–Shigella and depletion of Faecalibacterium. Several studies reported diagnostic and prognostic potential, with microbiome-based models achieving high predictive accuracy (AUC 0.77–0.94). Increased Veillonella abundance correlated with longer overall survival, while combined microbiome and C-reactive protein (CRP) profiles accurately predicted radiotherapy response in metastatic cases. A perioperative probiotic trial improved postoperative bowel function without increasing adverse events. The gut microbiome is strongly associated with brain tumors and holds promise as a diagnostic and prognostic biomarker. However, direct evidence from interventional studies on the efficacy of microbiota modulation for improving survival remains scarce and inconclusive. Future large, prospective, and controlled interventional trials are urgently needed to establish causality and therapeutic utility.