{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:24:40Z","timestamp":1791645880980,"version":"4.3.4"},"reference-count":91,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Gastric cancer (GC), often diagnosed at advanced or metastatic stages, remains a significant clinical challenge requiring novel biomarkers for early detection, risk stratification, and effective, personalized treatment optimization. Emerging evidence underscores a strong association between gut microbiome dysbiosis and GC initiation, progression, and therapeutic outcomes. This review explores the potential of the advanced\/metastatic gastric microbiome as a source of diagnostic and targetable biomarkers and its role in modulating responses to immunotherapy. Although Helicobacter pylori (H. pylori) is the most significant risk factor for GC, several other gastrointestinal taxa\u2014including Fusobacterium nucleatum (F. nucleatum)\u2014have been implicated in advanced GC (AGC). At its inception, microbial dysbiosis contributes to chronic inflammation and immune evasion, thereby influencing tumor behavior and treatment efficacy. Integrating microbiome-based biomarkers into risk stratification, GC staging, and targetable treatment frameworks may enhance early detection, inform immunotherapy strategies, and improve patient-specific treatment responses. Bifidobacterium and Lactobacillus rhamnosus GG have the potential to change the immunotherapy framework with their direct influence on dendritic cell (DC) and cytotoxic T cell (CTL) activity. However, clinical translation is impeded by methodological heterogeneity, causality limitations, and a lack of clinical trials. Nonetheless, the integration of microbiome profiling and the development of therapeutic microbiome modulation strategies, such as personalized probiotics regimens and fecal microbiota transplantation, hold substantial potential for improving clinical outcomes and reducing treatment-related toxicity in GC management.<\/jats:p>","DOI":"10.3390\/ijms27031452","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T09:00:33Z","timestamp":1770022833000},"page":"1452","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Microbiome Signatures in Advanced Gastric Cancer: Emerging Biomarkers for Risk Stratification, Therapy Guidance, and Prognostic Insight"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7713-3440","authenticated-orcid":false,"given":"Kyung-il John","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Kaiser Permanente Fontana Medical Center, 9961 Sierra Ave., Fontana, CA 92335, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, 1500 E Duarte Rd., Duarte, CA 91010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6461-5560","authenticated-orcid":false,"given":"Derek","family":"Tai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0331-892X","authenticated-orcid":false,"given":"Pranati","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Harbor-UCLA Medical Center, 1000 W Carson St., Torrance, CA 90502, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3521-6496","authenticated-orcid":false,"given":"Vitor","family":"Goes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627-Morumbi, S\u00e3o Paulo 05652-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianan","family":"Li","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology & Physical Education, University of Toronto, 100 Devonshire Place, Toronto, ON M5S 2C9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Jung","sequence":"additional","affiliation":[{"name":"Flintridge Preparatory School, 4543 Crown Ave., La Ca\u00f1ada Flintridge, CA 91011, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Medicine, Loma Linda University, 11175 Campus St., Loma Linda, CA 92350, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Guzman","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Therapeutics Research, City of Hope, 1500 E Duarte Rd., Duarte, CA 91010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gagandeep","family":"Brar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Therapeutics Research, City of Hope, 1500 E Duarte Rd., Duarte, CA 91010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dani","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Therapeutics Research, City of Hope, 1500 E Duarte Rd., Duarte, CA 91010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"ref_1","first-page":"26","article-title":"Epidemiology of gastric cancer: Global trends, risk factors and prevention","volume":"14","author":"Rawla","year":"2019","journal-title":"Prz. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wang, M., Yang, G., Tian, Y., Zhang, Q., Liu, Z., and Xin, Y. (2023). The role of the gut microbiota in gastric cancer: The immunoregulation and immunotherapy. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1183331"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"167","DOI":"10.6004\/jnccn.2022.0008","article-title":"Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology","volume":"20","author":"Ajani","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1038\/s41598-017-18596-0","article-title":"Increased Abundance of Clostridium and Fusobacterium in Gastric Microbiota of Patients with Gastric Cancer in Taiwan","volume":"8","author":"Hsieh","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1038\/s41388-022-02377-9","article-title":"Meta-analysis of mucosal microbiota reveals universal microbial signatures and dysbiosis in gastric carcinogenesis","volume":"41","author":"Liu","year":"2022","journal-title":"Oncogene"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1136\/gutjnl-2017-314281","article-title":"Mucosal microbiome dysbiosis in gastric carcinogenesis","volume":"67","author":"Coker","year":"2018","journal-title":"Gut"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1158\/0008-5472.CAN-24-2580","article-title":"Intratumoral Fusobacterium nucleatum Recruits Tumor-Associated Neutrophils to Promote Gastric Cancer Progression and Immune Evasion","volume":"85","author":"Zhang","year":"2025","journal-title":"Cancer Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1053\/j.gastro.2022.02.015","article-title":"Fecal Signatures of Streptococcus anginosus and Streptococcus constellatus for Noninvasive Screening and Early Warning of Gastric Cancer","volume":"162","author":"Zhou","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Wang, Y., Wang, Y., Han, W., Han, M., Liu, X., Dai, J., Dong, Y., Sun, T., and Xu, J. (2024). Intratumoral and fecal microbiota reveals microbial markers associated with gastric carcinogenesis. Front. Cell. Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1397466"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/SLA.0000000000005587","article-title":"A Novel Microbiome Signature in Gastric Cancer: A Two Independent Cohort Retrospective Analysis","volume":"276","author":"Abate","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"18594","DOI":"10.1038\/srep18594","article-title":"Different gastric microbiota compositions in two human populations with high and low gastric cancer risk in Colombia","volume":"6","author":"Yang","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1053\/j.gastro.2024.11.001","article-title":"AGA Clinical Practice Update on Screening and Surveillance in Individuals at Increased Risk for Gastric Cancer in the United States: Expert Review","volume":"168","author":"Shah","year":"2025","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sorino, J., Della Mura, M., Ingravallo, G., Cazzato, G., Pizzimenti, C., Zuccal\u00e0, V., Pepe, L., German\u00e0, E., Martini, M., and Ieni, A. (2025). Fusobacterium nucleatum and Gastric Cancer: An Emerging Connection. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26167915"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1053\/j.gastro.2016.11.018","article-title":"Fusobacterium nucleatum Increases Proliferation of Colorectal Cancer Cells and Tumor Development in Mice by Activating Toll-Like Receptor 4 Signaling to Nuclear Factor\u2212\u03baB, and Up-regulating Expression of MicroRNA-21","volume":"152","author":"Yang","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Consolo, P., Giorgi, C., Crisafulli, C., Fiorica, F., Pinton, P., Maurea, N., Missiroli, S., Quagliariello, V., Mantoan, B., and Ottaiano, A. (2025). Investigating the Impact of Fusobacterium nucleatum on Oxidative Stress, Chemoresistance, and Inflammation in Inflammatory Bowel Disease and Colorectal Cancer: Rationale and Design of a Clinical Trial. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26167823"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e14353","DOI":"10.1111\/eci.14353","article-title":"The emerging role of Fusobacteria in carcinogenesis","volume":"54","author":"Gibbs","year":"2024","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.biopha.2017.02.102","article-title":"Carcinogenesis mechanisms of Fusobacterium nucleatum","volume":"89","author":"Gholizadeh","year":"2017","journal-title":"Biomed. Pharmacother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1158\/1078-0432.CCR-16-0617","article-title":"Interleukin-17\u2013Producing Neutrophils Link Inflammatory Stimuli to Disease Progression by Promoting Angiogenesis in Gastric Cancer","volume":"23","author":"Li","year":"2017","journal-title":"Clin. Cancer Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s13046-018-1003-0","article-title":"Tumor-associated neutrophils induce EMT by IL-17a to promote migration and invasion in gastric cancer cells","volume":"38","author":"Li","year":"2019","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1501293","DOI":"10.3389\/fimmu.2024.1501293","article-title":"IL-17A in gastric carcinogenesis: Good or bad?","volume":"15","author":"Li","year":"2024","journal-title":"Front. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.cyto.2016.08.032","article-title":"Immunohistochemical expression and localization of cytokines\/chemokines\/growth factors in gastric cancer","volume":"89","author":"Raja","year":"2017","journal-title":"Cytokine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2360","DOI":"10.1111\/cas.15781","article-title":"Fusobacterium nucleatum-induced exosomal HOTTIP promotes gastric cancer progression through the MICRORNA-885-3p\/EPHB2 axis","volume":"114","author":"Xin","year":"2023","journal-title":"Cancer Sci."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Liu, W., Yu, C., Li, J., and Fang, J. (2022). The Roles of EphB2 in Cancer. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.788587"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2778","DOI":"10.7150\/jca.38098","article-title":"EphB2 represents an independent prognostic marker in patients with gastric cancer and promotes tumour cell aggressiveness","volume":"11","author":"Yin","year":"2020","journal-title":"J. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"151472","DOI":"10.1016\/j.ijmm.2021.151472","article-title":"Modulation of inflammatory responses by gastrointestinal Prevotella spp.\u2014From associations to functional studies","volume":"311","author":"Iljazovic","year":"2021","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"105673","DOI":"10.1016\/j.micpath.2022.105673","article-title":"Prevotella: An insight into its characteristics and associated virulence factors","volume":"169","author":"Sharma","year":"2022","journal-title":"Microb. Pathog."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/cas.16080","article-title":"Tumor-derived Prevotella intermedia aggravates gastric cancer by enhancing Perilipin 3 expression","volume":"115","author":"Liang","year":"2024","journal-title":"Cancer Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4640","DOI":"10.1038\/s41598-023-31740-3","article-title":"Microbial composition of tumorous and adjacent gastric tissue is associated with prognosis of gastric cancer","volume":"13","author":"Lehr","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/path.6277","article-title":"Cell division-dependent dissemination following E-cadherin loss underlies initiation of diffuse-type gastric cancer","volume":"263","author":"Monster","year":"2024","journal-title":"J. Pathol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1099\/jmm.0.007302-0","article-title":"Molecular characterization of the stomach microbiota in patients with gastric cancer and in controls","volume":"58","author":"Dicksved","year":"2009","journal-title":"J. Med. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/hel.12145","article-title":"Differences in Gastric Mucosal Microbiota Profiling in Patients with Chronic Gastritis, Intestinal Metaplasia, and Gastric Cancer Using Pyrosequencing Methods","volume":"19","author":"Eun","year":"2014","journal-title":"Helicobacter"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1038\/s41416-024-02753-0","article-title":"Presence of Fusobacterium nucleatum in relation to patient survival and an acidic environment in oesophagogastric junction and gastric cancers","volume":"131","author":"Hara","year":"2024","journal-title":"Br. J. Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.cell.2024.01.004","article-title":"Streptococcus anginosus promotes gastric inflammation, atrophy, and tumorigenesis in mice","volume":"187","author":"Fu","year":"2024","journal-title":"Cell"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s00432-025-06201-1","article-title":"Streptococcus anginosus: The potential role in the progression of gastric cancer","volume":"151","author":"Xia","year":"2025","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"142341","DOI":"10.1016\/j.ijbiomac.2025.142341","article-title":"Streptococcus anginosus promotes gastric cancer progression via GSDME-mediated pyroptosis pathway: Molecular mechanisms of action of GSDME, cleaved caspase-3, and NLRP3 proteins","volume":"307","author":"Wang","year":"2025","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/s41698-024-00522-z","article-title":"Targeting M2-like tumor-associated macrophages is a potential therapeutic approach to overcome antitumor drug resistance","volume":"8","author":"Wang","year":"2024","journal-title":"NPJ Precis. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Morgos, D.-T., Stefani, C., Miricescu, D., Greabu, M., Stanciu, S., Nica, S., Stanescu-Spinu, I.-I., Balan, D.G., Balcangiu-Stroescu, A.-E., and Coculescu, E.-C. (2024). Targeting PI3K\/AKT\/mTOR and MAPK Signaling Pathways in Gastric Cancer. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25031848"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Che, X., Zhang, Y., Chen, X., Xie, G., Li, J., Xu, C., Zhang, C., Zhu, Y., and Yang, X. (2025). The lactylation-macrophage interplay: Implications for gastrointestinal disease therapeutics. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1608115"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/s41586-019-1678-1","article-title":"Metabolic regulation of gene expression by histone lactylation","volume":"574","author":"Zhang","year":"2019","journal-title":"Nature"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Al-Malsi, K., Xie, S., Cai, Y., Mohammed, N., Xie, K., Lan, T., and Wu, H. (2025). The role of lactylation in tumor growth and cancer progression. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1516785"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3892\/or.2024.8839","article-title":"Lactate and lactylation in gastrointestinal cancer: Current progress and perspectives (Review)","volume":"53","author":"He","year":"2024","journal-title":"Oncol. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Tom\u00e1s, R., and P\u00e9rez-Guill\u00e9n, I. (2020). Lactate in the Tumor Microenvironment: An Essential Molecule in Cancer Progression and Treatment. Cancers, 12.","DOI":"10.3390\/cancers12113244"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"189339","DOI":"10.1016\/j.bbcan.2025.189339","article-title":"Research progress on the regulatory role of lactate and lactylation in tumor microenvironment","volume":"1880","author":"Gao","year":"2025","journal-title":"Biochim. Biophys. Acta Rev. Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"118156","DOI":"10.1016\/j.ejmech.2025.118156","article-title":"Synthesis, molecular modeling, biological and pharmacokinetic evaluation of hydroxy pyrimidinones and pyrimidinediones as novel LDHA inhibitors","volume":"300","author":"Sharma","year":"2025","journal-title":"Eur. J. Med. Chem."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e176851","DOI":"10.1172\/JCI176851","article-title":"Lactate reprograms glioblastoma immunity through CBX3-regulated histone lactylation","volume":"134","author":"Wang","year":"2024","journal-title":"J. Clin. Investig."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Baud, J., Varon, C., Chabas, S., Chambonnier, L., Darfeuille, F., and Staedel, C. (2013). Helicobacter pylori Initiates a Mesenchymal Transition through ZEB1 in Gastric Epithelial Cells. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0060315"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Chen, S., Li, S., Zheng, Y., Mai, L., and Zhang, X. (2025). Association of Helicobacter pylori related chronic atrophic gastritis and gastric cancer risk: A literature review. Front. Med., 12, Corrigendum in Front. Med.\u00a02025, 12, 1586952.","DOI":"10.3389\/fmed.2025.1586952"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"He, Z., Zhou, Y., Liu, J., Li, N., and Fan, H. (2025). The intersection of Helicobacter pylori and gastric cancer: Signaling pathways and molecular mechanisms. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1601501"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3490","DOI":"10.1038\/onc.2010.102","article-title":"ZEB1 represses E-cadherin and induces an EMT by recruiting the SWI\/SNF chromatin-remodeling protein BRG1","volume":"29","author":"Torrent","year":"2010","journal-title":"Oncogene"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"39209","DOI":"10.1074\/jbc.M206400200","article-title":"Snail Induction of Epithelial to Mesenchymal Transition in Tumor Cells Is Accompanied by MUC1 Repression andZEB1 Expression","volume":"277","author":"Guaita","year":"2002","journal-title":"J. Biol. Chem."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12929-025-01149-3","article-title":"Probiotics ameliorate H. pylori-associated gastric \u03b2-catenin and COX-2 carcinogenesis signaling by regulating miR-185","volume":"32","author":"Yang","year":"2025","journal-title":"J. Biomed. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.3892\/or.2013.2267","article-title":"Downregulated microRNA-200a promotes EMT and tumor growth through the Wnt\/\u03b2-catenin pathway by targeting the E-cadherin repressors ZEB1\/ZEB2 in gastric adenocarcinoma","volume":"29","author":"Cong","year":"2013","journal-title":"Oncol. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Longhi, G., Van Sinderen, D., Ventura, M., and Turroni, F. (2020). Microbiota and Cancer: The Emerging Beneficial Role of Bifidobacteria in Cancer Immunotherapy. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.575072"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2704","DOI":"10.1056\/NEJMra072739","article-title":"Cancer Immunology","volume":"358","author":"Finn","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ijfoodmicro.2009.12.023","article-title":"Distinct Bifidobacterium strains drive different immune responses in vitro","volume":"138","author":"Gueimonde","year":"2010","journal-title":"Int. J. Food Microbiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1128\/IAI.01446-06","article-title":"Interleukin-12 Drives the Th1 Signaling Pathway in Helicobacter pylori-Infected Human Gastric Mucosa","volume":"75","author":"Sebkova","year":"2007","journal-title":"Infect. Immun."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1001\/jamaoncol.2022.0494","article-title":"The Potential of the Gut Microbiome to Reshape the Cancer Therapy Paradigm: A Review","volume":"8","author":"Liu","year":"2022","journal-title":"JAMA Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2300846","DOI":"10.1080\/19490976.2023.2300846","article-title":"Gut microbiome-derived butyrate inhibits the immunosuppressive factors PD-L1 and IL-10 in tumor-associated macrophages in gastric cancer","volume":"16","author":"Lee","year":"2024","journal-title":"Gut Microbes"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"106813","DOI":"10.1016\/j.biocel.2025.106813","article-title":"Bifidobacterium apoptosis induction by measuring bax and caspases on SW948 human colon cancer cell line","volume":"186","author":"Soraya","year":"2025","journal-title":"Int. J. Biochem. Cell Biol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1200\/JCO.23.01601","article-title":"First-Line Nivolumab Plus Chemotherapy for Advanced Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinoma: 3-Year Follow-Up of the Phase III CheckMate 649 Trial","volume":"42","author":"Janjigian","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/S1470-2045(23)00515-6","article-title":"Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric cancer (KEYNOTE-859): A multicentre, randomised, double-blind, phase 3 trial","volume":"24","author":"Rha","year":"2023","journal-title":"Lancet Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/S1470-2045(21)00692-6","article-title":"Nivolumab plus chemotherapy versus placebo plus chemotherapy in patients with HER2-negative, untreated, unresectable advanced or recurrent gastric or gastro-oesophageal junction cancer (ATTRACTION-4): A randomised, multicentre, double-blind, placebo-controlled, phase 3 trial","volume":"23","author":"Kang","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Van Schooten, T.S., Derks, S., Jim\u00e9nez-Mart\u00ed, E., Carneiro, F., Figueiredo, C., Ruiz, E., Alsina, M., Molero, C., Garrido, M., and Riquelme, A. (2022). The LEGACy study: A European and Latin American consortium to identify risk factors and molecular phenotypes in gastric cancer to improve prevention strategies and personalized clinical decision making globally. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-09689-9"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1136\/gutjnl-2024-333617","article-title":"CAF-macrophage crosstalk in tumour microenvironments governs the response to immune checkpoint blockade in gastric cancer peritoneal metastases","volume":"74","author":"Li","year":"2025","journal-title":"Gut"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"605","DOI":"10.5230\/jgc.2025.25.e46","article-title":"Distinct Immunosuppressive Tumor Microenvironment in Gastric Cancer With Peritoneal Metastasis","volume":"25","author":"Kim","year":"2025","journal-title":"J. Gastric Cancer"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"32090","DOI":"10.1038\/s41598-025-13892-6","article-title":"Comprehensive analysis of the tumor immune microenvironment in gastric cancer and peritoneal metastasis based on single-cell RNA sequencing analysis","volume":"15","author":"Sun","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e009243","DOI":"10.1136\/jitc-2024-009243","article-title":"Mapping the complexity and diversity of tertiary lymphoid structures in primary and peritoneal metastatic gastric cancer","volume":"12","author":"Bos","year":"2024","journal-title":"J. Immunother. Cancer"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1126\/science.aac4255","article-title":"Commensal Bifidobacterium promotes antitumor immunity and facilitates anti\u2013PD-L1 efficacy","volume":"350","author":"Sivan","year":"2015","journal-title":"Science"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1038\/s41564-020-00831-6","article-title":"Bifidobacterium bifidum strains synergize with immune checkpoint inhibitors to reduce tumour burden in mice","volume":"6","author":"Lee","year":"2021","journal-title":"Nat. Microbiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1136\/gutjnl-2020-323426","article-title":"Lactobacillus rhamnosus GG induces cGAS\/STING- dependent type I interferon and improves response to immune checkpoint blockade","volume":"71","author":"Si","year":"2022","journal-title":"Gut"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"10314","DOI":"10.1039\/D3FO02018E","article-title":"Dietary Lactobacillus rhamnosus GG extracellular vesicles enhance antiprogrammed cell death 1 (anti-PD-1) immunotherapy efficacy against colorectal cancer","volume":"14","author":"Lu","year":"2023","journal-title":"Food Funct."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1200\/JCO.2023.41.4_suppl.379","article-title":"Retrospective analysis of drug intake affecting the intestinal microbiota and the therapeutic effects of chemotherapy on gastric cancer","volume":"41","author":"Nakamura","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1200\/JCO.2021.39.3_suppl.161","article-title":"Genomic pathway of gut microbiome to predict efficacy of nivolumab in advanced gastric cancer: DELIVER trial (JACCRO GC-08)","volume":"39","author":"Sunakawa","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"100923","DOI":"10.1016\/j.neo.2023.100923","article-title":"Checkpoint inhibitor responses can be regulated by the gut microbiota\u2014A systematic review","volume":"43","author":"Zeriouh","year":"2023","journal-title":"Neoplasia"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2307542","DOI":"10.1080\/19490976.2024.2307542","article-title":"Gut microbiota modulate CD8+ T cell immunity in gastric cancer through Butyrate\/GPR109A\/HOPX","volume":"16","author":"Yu","year":"2024","journal-title":"Gut Microbes"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"152398","DOI":"10.1016\/j.seminoncol.2025.152398","article-title":"The effects of microbiota-derived short-chain fatty acids on T lymphocytes: From autoimmune diseases to cancer","volume":"52","author":"Saadh","year":"2025","journal-title":"Semin. Oncol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"110343","DOI":"10.1016\/j.ejso.2025.110343","article-title":"The role of gut microbiota in the perioperative management of gastric cancer and intervention methods: A systematic review","volume":"51","author":"Tang","year":"2025","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Liu, G., Cao, S., Liu, X., Tian, Y., Yu, W., Chai, J., Li, L., Wang, X., Chu, X., and Duan, Q. (2025). Effect of perioperative probiotic supplements on the short-term clinical outcomes of patients undergoing laparoscopic or robotic radical gastrectomy after neoadjuvant chemotherapy: Study protocol for a multicenter randomized controlled trial (GISSG2023-01 Study). BMC Cancer, 25.","DOI":"10.1186\/s12885-025-14115-x"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"5240","DOI":"10.1245\/s10434-024-15394-7","article-title":"Probiotic Compounds Enhanced Recovery after Surgery for Patients with Distal Gastric Cancer: A Prospective, Controlled Clinical Trial","volume":"31","author":"Xiong","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"568","DOI":"10.7150\/jca.29072","article-title":"A randomised trial of probiotics to reduce severity of physiological and microbial disorders induced by partial gastrectomy for patients with gastric cancer","volume":"10","author":"Zheng","year":"2019","journal-title":"J. Cancer"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/COC.0000000000001158","article-title":"Efficacy and Safety of Probiotics as Adjunctive Therapy in Cancer Treatment: A Comprehensive Systematic Review and Meta-Analysis","volume":"48","author":"Qureshi","year":"2025","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1053\/j.gastro.2020.05.059","article-title":"AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders","volume":"159","author":"Su","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1053\/j.gastro.2020.05.060","article-title":"AGA Technical Review on the Role of Probiotics in the Management of Gastrointestinal Disorders","volume":"159","author":"Preidis","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Feldman, K., Noel-MacDonnell, J.R., Pappas, L.B., Romald, J.H., Olson, S.L., Oschman, A., Cuna, A.C., and Sampath, V. (2025, November 17). Incidence of probiotic sepsis and morbidity risk in premature infants: A meta-analysis. Pediatr. Res. 2025, ahead of print. Available online: https:\/\/www.nature.com\/articles\/s41390-025-04072-3.","DOI":"10.1038\/s41390-025-04072-3"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.1007\/s00431-022-04452-5","article-title":"Probiotic sepsis in preterm neonates\u2014A systematic review","volume":"181","author":"Kulkarni","year":"2022","journal-title":"Eur. J. Pediatr."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Farella, I., Fortunato, M., Martinelli, D., De Carlo, C., Sparapano, E., Stolfa, S., Romanelli, F., De Laurentiis, V., Martinotti, S., and Capozzi, L. (2025). Lactobacillus rhamnosus Sepsis in a Preterm Infant Following Probiotic Administration: Challenges in Diagnosis. Microorganisms, 13.","DOI":"10.3390\/microorganisms13020265"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.jmii.2020.03.029","article-title":"Lactobacillus rhamnosus sepsis associated with probiotic therapy in an extremely preterm infant: Pathogenesis and a review for clinicians","volume":"54","author":"Chiang","year":"2021","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1097\/CCM.0000000000005953","article-title":"Probiotic-Associated Central Venous Catheter Bloodstream Infections Lead to Increased Mortality in the ICU*","volume":"51","author":"Mayer","year":"2023","journal-title":"Crit. Care Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/S1470-2045(18)30952-5","article-title":"Modulating the microbiome to improve therapeutic response in cancer","volume":"20","author":"McQuade","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/j.bbrc.2015.12.083","article-title":"Analysis of the microbiome: Advantages of whole genome shotgun versus 16S amplicon sequencing","volume":"469","author":"Ranjan","year":"2016","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"7668","DOI":"10.1038\/s41598-023-33489-1","article-title":"Shallow shotgun sequencing reduces technical variation in microbiome analysis","volume":"13","author":"Strom","year":"2023","journal-title":"Sci. Rep."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/3\/1452\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:13:40Z","timestamp":1770182020000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/3\/1452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,31]]},"references-count":91,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["ijms27031452"],"URL":"https:\/\/doi.org\/10.3390\/ijms27031452","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,31]]}}}