Влияние внутриопухолевого микробиома на терапию рака поджелудочной железы
https://doi.org/10.25789/YMJ.2026.93.23
Аннотация
Рак поджелудочной железы (РПЖ) представляет собой одну из наиболее сложных проблем современной онкологии. Он отличается повышающимися с каждым годом показателями заболеваемости, крайне низкими показателями выживаемости, агрессивным и нередко бессимптомным течением, что ставит вопрос о необходимости поиска более эффективных терапевтических стратегий. В настоящее время манипуляция микробиомом рассматривается как мощный вспомогательный инструмент, который может повысить эффективность существующих методов лечения. Данный обзор обобщает современные данные о роли внутриопухолевого микробиома в терапии РПЖ, рассматривая его влияние на эффективность лечения и обсуждая потенциал таргетного воздействия на микробные сообщества как вспомогательного метода, способного улучшить исходы пациентов.
Ключевые слова
Об авторах
М. С. ФедороваРоссия
Федорова Мария Сергеевна – канд. биол. наук, мл. науч. сотр.,
ул. Вавилова, д. 32, г. Москва, 119991
А. А. Филатова
Россия
Филатова Алёна Алексеевна – врачпатологоанатом,
ул. Большая Серпуховская, д. 27, г. Москва, 117997
Д. В. Калинин
Россия
Калинин Дмитрий Валерьевич – канд. мед. наук, зав. патологоанатомическим отделением,
ул. Большая Серпуховская, д. 27, г. Москва, 117997
В. С. Павлов
Россия
Павлов Владислав Сергеевич – канд. биол. наук, мл. науч. сотр.,
ул. Вавилова, д. 32, г. Москва, 119991
Список литературы
1. Набока М. В., Отмахова А. В., Богданчикова П. В. и др. Эпидемиология рака поджелудочной железы. Экспериментальная и клиническая гастроэнтерология. 2023; 211(3): 17–21. DOI: 10.31146/1682-8658-ecg211-3-17-2.
2. Российское общество клинической онкологии (RUSSCO). Стандарты оперативной практики (СОП) в онкологии: электронная версия 2023 года [интернет]. 2023 [обновлено 2023; процитировано 2024-06-24]. Онкологическая ассоциация России. https://oncology-association.ru/wp-content/uploads/2024/06/sop-2023-elektronnaya-versiya.pdf.
3. Jamal M.H., Porel P., Aran K.R. Emerging biomarkers for pancreatic cancer: from early detection to personalized therapy. Clinical and Translational Oncology. 2025; 27(11): 4071-4090. https://doi.org/10.1007/s12094-025-03947-5. Epub 2025 May 10, PMID: 40348906.
4. Zheng R., Liu X., Zhang Y. et al. Frontiers and future of immunotherapy for pancreatic cancer: from molecular mechanisms to clinical application. Frontiers in Immunology. 2024; 15:1383978. https://doi.org/10.3389/fimmu.2024.1383978. Epub 2024 May 02. PMID: 38756774; PMCID: PMC11096556.
5. Dorman K., Zhang D., Heinrich K. et al. Precision Oncology in Pancreatic Cancer: Experiences and Challenges of the CCCMunichLMU Molecular Tumor Board. Targeted Oncology. 2023; 18(2): 257-267. https://doi.org/10.1007/s11523-023-00950-0. Epub 2023 Feb 28. PMID: 36853374; PMCID: PMC10042756.
6. Mouawad A., Habib S., Boutros M. et al. How to find a needle in a haystack: a systematic review on targeting KRAS wild-type pancreatic cancer. Future Oncology. 2024; 20(40): 3539- 3547. https://doi.org/10.1080/14796694.2024.2355078. Epub 2024 Jun 05. PMID: 38861291; PMCID: PMC11776852.
7. Riquelme E., Zhang Y., Zhang L. et al. Tumor Microbiome Diversity and Composition Influence Pancreatic Cancer Outcomes. Cell. 2019; 178(4): 795-806.e712. https://doi.org/10.1016/j.cell.2019.07.008. Epub 2019 Aug 8. PMID: 31398337; PMCID: PMC7288240.
8. Eckhoff A.M., Fletcher A.A., Kelly M.S. et al. Comprehensive Assessment of the Intrinsic Pancreatic Microbiome. Annals of Surgery. 2025; 282(6): 1060-1069. https://doi.org/10.1097/sla.0000000000006299. Epub 2025 Dec 1, PMID: 38623754; PMCID: PMC11480254.
9. May M.S., Park H., Moallem D.H. et al. Low Bacterial Biomass in Human Pancreatic Cancer and Adjacent Normal Tissue. International Journal of Molecular Sciences. 2024; 26(1): https://doi.org/10.3390/ijms26010140. Epub 2024 Dec 27. PMID: 39795998; PMCID: PMC11720454.
10. Nalluri H., Jensen E., Staley C. Role of biliary stent and neoadjuvant chemotherapy in the pancreatic tumor microbiome. BMC Microbiol. 2021; 21(1): 280. https://doi.org/10.1186/s12866-021-02339-3. Epub 2021 Oct 16, PMID: 34656097; PMC8520243.
11. Geller L.T., Barzily-Rokni M., Danino T. et al. Potential role of intratumor bacteria in mediating tumor resistance to the chemotherapeutic drug gemcitabine. Science. 2017; 357(6356): 1156-1160. https://doi.org/10.1126/science.aah5043. Epub 2017 Sep 15. PMID: 28912244; PMCID: PMC5727343.
12. Ciccolini J., Serdjebi C., Peters G.J. et al. Pharmacokinetics and pharmacogenetics of Gemcitabine as a mainstay in adult and pediatric oncology: an EORTC-PAMM perspective. Cancer Chemother Pharmacol. 2016; 78(1): 1-12. https://doi.org/10.1007/s00280-016-3003-0. Epub 2016 Mar 24. PMID: 27007129; PMC4921117.
13. Kabwe M., Dashper S., Tucci J. The Microbiome in Pancreatic Cancer-Implications for Diagnosis and Precision Bacteriophage Therapy for This Low Survival Disease. Front Cell Infect Microbiol. 2022; 12(871293. https://doi.org/10.3389/fcimb.2022.871293. Epub 2022 Jun 07. PMID: 35663462; PMC9160434.
14. Cheo S.W., Lee J.W.J., Walsh R.J. et al. Ciprofloxacin plus gemcitabine-based chemotherapy in patients with metastatic pancreatic ductal adenocarcinoma: A pilot study of microbiome manipulation. Journal of Clinical Oncology. 2022; 40(4_suppl): 570-570. https://doi.org/10.1200/JCO.2022.40.4_suppl.570.
15. Gong E., Fulop D.J., Serebrenik J. et al. Antibiotic treatment and survival in patients with resected, early-stage pancreatic ductal adenocarcinoma receiving chemotherapy. JNCI Cancer Spectr. 2025; 9(2): pkaf024. https://doi.org/10.1093/jncics/pkaf024. Epub 2025 Feb 21, PMID: 39982394, PMC11917212.
16. Corty R.W., Langworthy B.W., Fine J.P. et al. Antibacterial Use Is Associated with an Increased Risk of Hematologic and Gastrointestinal Adverse Events in Patients Treated with Gemcitabine for Stage IV Pancreatic Cancer. The Oncologist. 2020; 25(7): 579-584. https://doi.org/10.1634/theoncologist.2019-0570. Epub 2020 Mar 17, PMID: 32181968, PMCID: PMC7356778.
17. Bjanes T.K., Jordheim L.P., Schjott J. et al. Intracellular Cytidine Deaminase Regulates Gemcitabine Metabolism in Pancreatic Cancer Cell Lines. Drug Metab Dispos. 2020; 48(3): 153-158. https://doi.org/10.1124/dmd.119.089334. Epub 2019 Dec 25, PMID: 31871136; PMC11022907.
18. Yeung C.Y., Chiang Chiau J.S., Cheng M.L. et al. Modulations of probiotics on gut microbiota in a 5-fluorouracil-induced mouse model of mucositis. J Gastroenterol Hepatol. 2020; 35(5): 806-814. https://doi.org/10.1111/jgh.14890. Epub 2019 Nov 13. PMID: 31674687.
19. Garcia-Gonzalez A.P., Ritter A.D., Shrestha S. et al. Bacterial Metabolism Affects the C. elegans Response to Cancer Chemotherapeutics. Cell. 2017; 169(3): 431-441. https://doi.org/10.1016/j.cell.2017.03.046. Epub 2017 Apr 22, PMID: 28431244; PMCID: PMC5484065.
20. Carpenter E., Nelson S., Bednar F. et al. Immunotherapy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2021; 123(3): 751-759. https://doi.org/10.1002/jso.26312. Epub 2021 Feb 18. PMID: 33595893.
21. Schizas D., Charalampakis N., Kole C. et al. Immunotherapy for pancreatic cancer: A 2020 update. Cancer Treat Rev. 2020; 86: 102016. https://doi.org/10.1016/j.ctrv.2020.102016. Epub 2020 Mar 25. PMID: 30660727; PMCID: PMC6486864,
22. Balachandran V.P., Beatty G.L., Dougan S.K. Broadening the Impact of Immunotherapy to Pancreatic Cancer: Challenges and Opportunities. Gastroenterology. 2019; 156(7): 2056-2072. https://doi.org/10.1053/j.gastro.2018.12.038. Epub 2019 Jan 18, PMC6486864.
23. Pushalkar S., Hundeyin M., Daley D. et al. The Pancreatic Cancer Microbiome Promotes Oncogenesis by Induction of Innate and Adaptive Immune Suppression. Cancer Discovery. 2018; 8(4): 403-416. https://doi.org/10.1158/2159-8290.cd-17-1134. Epub 2018 Mar 22. PMID: 29567829; PMCID: PMC6225783.
24. 4D pharma plc. A Phase I/II Open Label, Safety And Preliminary Efficacy Study of MRx0518 In Combination With Pembrolizumab In Patients With Advanced Malignancies Who Have Progressed On PD-1/PD-L1 Inhibitors. Clinical Trials. Gov identifier: NCT03637803. https://clinicaltrials.gov/study/NCT03637803. First posted: August 20, 2018. Last update posted: September 8, 2023.
25. National Cancer Institute (NCI). Phase II Study of Nivolumab (Anti-PD1), Tadalafil and Oral Vancomycin in Patients With Refractory Primary Hepatocellular Carcinoma or Liver Dominant Metastatic Cancer From Colorectal or Pancreatic Cancers. ClinicalTrials.gov identifier: NCT03785210. https://clinicaltrials.gov/study/NCT03785210. First posted: December 24, 2018. Last update posted: February 23, 2023.
26. Tan W., Duong M.T., Zuo C. et al. Targeting of pancreatic cancer cells and stromal cells using engineered oncolytic Salmonella typhimurium. Mol Ther. 2022; 30(2): 662-671. https://doi.org/10.1016/j.ymthe.2021.08.023. Epub 2021 Aug 14. PMID: 34400328; PMCID: PMC8821930.
27. Ebelt N.D., Zamloot V., Zuniga E. et al. Collagenase-Expressing Salmonella Targets Major Collagens in Pancreatic Cancer Leading to Reductions in Immunosuppressive Subsets and Tumor Growth. Cancers (Basel). 2021; 13(14): 3565. https://doi.org/10.3390/cancers13143565. Epub 2021 Jul 16, PMID: 34298778; PMCID: PMC8306875.
28. Kim V.M., Blair A.B., Lauer P. et al. Anti-pancreatic tumor efficacy of a Listeria-based, Annexin A2-targeting immunotherapy in combination with anti-PD-1 antibodies. J Immunother Cancer. 2019; 7(1): 132. https://doi.org/10.1186/s40425-019-0601-5. Epub 2019 May 23, PMID: 31113479; PMCID: PMC6529991.
29. Sethi V., Vitiello G.A., Saxena D. et al. The Role of the Microbiome in Immunologic Development and its Implication For Pancreatic Cancer Immunotherapy. Gastroenterology. 2019; 156(7): 2097-2115.e2. https://doi.org/10.1053/j.gastro.2018.12.045. Epub 2019 Feb 12. PMID: 30768986.
30. M.D. Anderson Cancer Center. Pilot Study Using Fecal Microbial Transplants in Patients With Pancreatic Cancer. ClinicalTrials.gov identifier: NCT04975217. https://clinicaltrials.gov/study/NCT04975217. First posted: July 23, 2021. Last update posted: November 21, 2025.
31. The First Affiliated Hospital of Nanchang University. Fecal Microbiota Transplantation in SAP (Severe Acute Pancreatitis) Patients With Intestinal Barrier Dysfunction. ClinicalTrials.gov identifier: NCT02318134. https://clinicaltrials.gov/study/NCT02318134. First posted (estimated): December 17, 2014. Last update posted: April 14, 2021.
32. Rezasoltani S., Yadegar A., Asadzadeh Aghdaei H. et al. Modulatory effects of gut microbiome in cancer immunotherapy: A novel paradigm for blockade of immune checkpoint inhibitors. Cancer Med. 2021; 10(3): 1141-1154. https://doi.org/10.1002/cam4.3694. Epub 2020 Dec 25, PMID: 33369247; PMCID: PMC7897953.
33. Bernard V., Noticewala S., Ludmir E. et al. 629-A A safety and feasibility study of the oral live biotherapeutic MRx0518 with hypofractionated preoperative radiation for resectable pancreatic cancer. J Immunother Cancer: Regular Abstracts – Part 2. 2023; 11(Suppl 1): A1–A1731. https://doi.org/10.1136/jitc-2023-SITC2023.0629-A.
34. Vruzhaj I., Gambirasi M., Busato D. et al. Gut Microbiota-Based Immunotherapy: Engineered Escherichia coli Nissle 1917 for Oral Delivery of Glypican-1 in Pancreatic Cancer. Medicina. 2025; 61(4): 633. https://doi.org/10.3390/medicina61040633. Epub 2025 Mar 30. PMID: 40282924; PMCID: PMC12028767.
35. Boursi B., Mamtani R., Haynes K. et al. Recurrent antibiotic exposure may promote cancer formation – Another step in understanding the role of the human microbiota? European Journal of Cancer. 2015; 51(17): 2655-2664. https://doi.org/10.1016/j.ejca.2015.08.015. Epub 2015 Aug 31. PMID: 26338196; PMCID: PMC4663115.
36. Theochari N.A., Stefanopoulos A., Mylonas K.S. et al. Antibiotics exposure and risk of inflammatory bowel disease: a systematic review. Scandinavian Journal of Gastroenterology. 2017; 53(1): 1-7. https://doi.org/10.1080/00365521.2017.1386711. Epub 2017 Oct 12. PMID: 29022402
37. Dicks L.M.T., Mikkelsen L.S., Brandsborg E. et al. Clostridium difficile, the Difficult “Kloster” Fuelled by Antibiotics. Current Microbiology. 2018; 76(6): 774-782. https://doi.org/10.1007/s00284-018-1543-8. Epub 2018 Aug 6. PMID: 30084095.
38. Abdul Rahman R., Lamarca A., Hubner R.A. et al. The Microbiome as a Potential Target for Therapeutic Manipulation in Pancreatic Cancer. Cancers. 2021; 13(15): 3779. https://doi.org/10.3390/cancers13153779. Epub 2021 Jul 27. PMID: 34359684; PMCID: PMC8345056.
39. Belizário J.E., Napolitano M. Human microbiomes and their roles in dysbiosis, common diseases, and novel therapeutic approaches. Frontiers in Microbiology. 2015; 6: 1050. https://doi.org/10.3389/fmicb.2015.01050. Epub 2015 Oct 6. PMID: 26500616; PMCID: PMC4594012.
40. Clavijo V., Flórez M.J.V. The gastrointestinal microbiome and its association with the control of pathogens in broiler chicken production: A review. Poultry Science. 2018; 97(3): 1006-1021. https://doi.org/10.3382/ps/pex359. Epub 2018 Mar 1. PMID: 29253263; PMCID: PMC5850219.
41. Paule A., Frezza D., Edeas M. Microbiota and Phage Therapy: Future Challenges in Medicine. Medical Sciences. 2018; 6(4): 86. https://doi.org/10.3390/medsci6040086. Epub 2018 Oct 5. PMID: 30301167; PMCID: PMC6313512.
42. Shabbir M.A.B., Hao H., Shabbir M.Z. et al. Bacteria vs. Bacteriophages: Parallel Evolution of Immune Arsenals. Frontiers in Microbiology. 2016; 7: 1292. https://doi.org/10.3389/fmicb.2016.01292. Epub 2016 Aug 17. PMID: 27582740; PMCID: PMC4987407.
43. Schooley R.T., Biswas B., Gill J.J. et al. Development and Use of Personalized Bacteriophage-Based Therapeutic Cocktails To Treat a Patient with a Disseminated Resistant Acinetobacter baumannii Infection. Antimicrobial Agents and Chemotherapy. 2017; 61(10): e00954-17. https://doi.org/10.1128/aac.00954-17. Epub 2017 Sep 22. PMID: 28807909; PMCID: PMC5610518.
44. Machuca P., Daille L., Vinés E. et al. Isolation of a Novel Bacteriophage Specific for the Periodontal Pathogen Fusobacterium nucleatum. Applied and Environmental Microbiology. 2010; 76(21): 7243-7250. https://doi.org/10.1128/aem.01135-10. Epub 2010 Sep 17. PMID: 20851973; PMCID: PMC2976222.
45. Mizuno C.M., Luong T., Cederstrom R. et al. Isolation and Characterization of Bacteriophages That Infect Citrobacter rodentium, a Model Pathogen for Intestinal Diseases. Viruses. 2020; 12(7): 737. https://doi.org/10.3390/v12070737. Epub 2020 Jul 8. PMID: 32650458; PMCID: PMC7412075.
46. Adamczyk-Popławska M., Tracz-Gaszewska Z., Lasota P. et al. Haemophilus influenzae HP1 Bacteriophage Encodes a Lytic Cassette with a Pinholin and a Signal-Arrest-Release Endolysin. International Journal of Molecular Sciences. 2020; 21(11): 4013. https://doi.org/10.3390/ijms21114013. Epub 2020 Jun 4. PMID: 32512736; PMCID: PMC7312051.
47. Kabwe M., Dashper S., Tucci J. The Microbiome in Pancreatic Cancer-Implications for Diagnosis and Precision Bacterioph age Therapy for This Low Survival Disease. Frontiers in Cellular and Infection Microbiology. 2022; 12: 871293. https://doi.org/10.3389/fcimb.2022.871293. Epub 2022 May 19. PMID: 35663462; PMCID: PMC9160434.
Рецензия
Для цитирования:
Федорова М.С., Филатова А.А., Калинин Д.В., Павлов В.С. Влияние внутриопухолевого микробиома на терапию рака поджелудочной железы. Якутский медицинский журнал. 2026;(1):111-115. https://doi.org/10.25789/YMJ.2026.93.23
For citation:
Fedorova M.S., Filatova A.A., Kalinin D.V., Pavlov V.S. The influence of the intratumor microbiome on pancreatic cancer therapy. Yakut Medical Journal. 2026;(1):111-115. (In Russ.) https://doi.org/10.25789/YMJ.2026.93.23
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