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However, a significant proportion of patients with HCC, particularly those with metabolic dysfunction\u2010associated liver disease (MASLD), exhibit resistance to ICI therapy. Studies have revealed that the presence of specific gut bacteria, such as\n                    <jats:italic>Akkermansia<\/jats:italic>\n                    ,\n                    <jats:italic>Bifidobacterium<\/jats:italic>\n                    , and\n                    <jats:italic>Lachnoclostridium<\/jats:italic>\n                    , is associated with improved outcomes with ICI\u2010treated HCC patients. Conversely, the overgrowth of bacteria like\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    is linked to resistance to therapy. This review investigates the role of gut microbiota in shaping immune checkpoint inhibitor responses in MASLD\u2010related 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.\n                  <\/jats:p>","DOI":"10.1002\/cam4.71738","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:07:13Z","timestamp":1774609633000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Influence of Gut Microbiota on Response to Immune Check Point Inhibitors in\n                    <scp>MASLD<\/scp>\n                    Patients With\n                    <scp>HCC<\/scp>\n                    : Unraveling the Connection"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6527-086X","authenticated-orcid":false,"given":"Mazen","family":"Elsheikh","sequence":"first","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Ali","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Fares","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha","family":"Bhongade","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Adhem","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximena I.","family":"Ramirez\u2010Morales","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9491-0587","authenticated-orcid":false,"given":"Ahmed O.","family":"Kaseb","sequence":"additional","affiliation":[{"name":"Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology The University of Texas, MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Petrosino","sequence":"additional","affiliation":[{"name":"Department of Molecular Virology and Microbiology, Alkek Center for Metagenomics and Microbiome Research Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal M.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Population Sciences, Department of Epidemiology The University of Texas, MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5353-2324","authenticated-orcid":false,"given":"Prasun K.","family":"Jalal","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2025.102881"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms231911363"},{"key":"e_1_2_14_4_1","article-title":"Immune Checkpoint Inhibitors as a Treatment Option for Bladder Cancer: Current Evidence","volume":"15","author":"Okobi T. 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