The intestinal microbiome plays a significant role in modulation of the immune system and carcinogenesis. An increasing number of studies are now investigating the microbiome and the effect of dysbiosis on urological diseases.
Studies investigating the bacterial composition of urine and prostate tissue as well as fecal bacteria clearly demonstrated an association between the alteration in bacterial composition and prostate cancer. Furthermore, patients with and without prostate cancer seem to have a distinct cluster of bacteria that alter metabolic pathways including androgen and testosterone synthesis.
Apart from the interaction of the immune system and microbial composition, there is compelling evidence that the microbiome is involved in modulation of treatment efficacy. Therefore, a dysbiosis of the intestinal microbiome compromises the efficacy of PD-1 immunotherapy. Furthermore, androgen deprivation therapies (ADT), as well as androgen receptor targeting agents (ARTA) including bicalutamide, enzalutamide, and abiraterone acetate, seem to have an influence on the intestinal microbiome.
Microbiome research is a virgin soil in science and will provide further insights into a new area that affects the development of cancer. Based on this information, new therapeutic strategies and prevention options could be found in the future.