Language

English

Publication Date

4-1-2026

Journal

Cancer Medicine

DOI

10.1002/cam4.71738

PMID

41891399

PMCID

PMC13140595

PubMedCentral® Posted Date

3-27-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Immune checkpoint inhibitors (ICIs) have emerged as a promising treatment for various cancers, including advanced hepatocellular carcinoma (HCC). However, a significant proportion of patients with HCC, particularly those with metabolic dysfunction-associated liver disease (MASLD), exhibit resistance to ICI therapy. Studies have revealed that the presence of specific gut bacteria, such as Akkermansia, Bifidobacterium, and Lachnoclostridium, is associated with improved outcomes with ICI-treated HCC patients. Conversely, the overgrowth of bacteria like Enterobacteriaceae is linked to resistance to therapy. This review investigates the role of gut microbiota in shaping immune checkpoint inhibitor responses in MASLD-related hepatocellular carcinoma, focusing on how dysbiosis may contribute to ICI resistance and exploring microbiome modulation strategies, such as fecal microbiota transplantation and probiotics, aiming to optimize therapeutic outcomes.

Keywords

Humans, Immune Checkpoint Inhibitors, Carcinoma, Hepatocellular, Liver Neoplasms, Gastrointestinal Microbiome, Fecal Microbiota Transplantation, Dysbiosis, Liver Diseases, dysbiosis, fecal microbial transplantation, immune checkpoint inhibitors

Published Open-Access

yes

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