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  • The Gut Microbiome as a Modulator of Cancer Immunotherapy: Emerging Roles for Advanced Nursing Nutrition and Care Interventions

  • Sharareh Zeighami Mohammadi,1,*
    1. PhD in Nursing, Assistant Professor, Clinical Cares and Health Promotion Research Center, Karaj Branch, Islamic Azad University, Karaj, Iran . E-mail: Zeighami20@yahoo.com Tel: +989125680679


  • Introduction: The clinical efficacy of Immune Checkpoint Inhibitors (ICIs) is significantly influenced by the diversity and composition of the gut microbiota. Recent evidence suggests that a symbiotic microbiome enhances systemic immunity and optimizes the therapeutic response to ICIs. However, clinical nursing often overlooks the potential of microbiome modulation as a supportive oncological therapy. This review aims to synthesize recent evidence on how nursing-led lifestyle and nutritional interventions can strategically modulate the gut-tumor axis to enhance immunotherapy outcomes.
  • Methods: A comprehensive literature review was performed across PubMed, EMBASE, and CINAHL (2021–2026). The analysis focused on clinical trials and mechanistic studies investigating the impact of dietary fibers, probiotics, and the avoidance of dysbiosis-inducing agents (e.g., unnecessary antibiotics) on ICI efficacy in patients with melanoma, NSCLC, and renal cell carcinoma.
  • Results: The results indicate that high-fiber diets and specific bacterial taxa (e.g., Akkermansia muciniphila, Bifidobacterium) are positively correlated with improved Progression-Free Survival (PFS). Conversely, antibiotic-induced dysbiosis is linked to primary resistance to ICIs. A key finding is the pivotal role of “Microbiome-Conscious Nursing.” Nurses are uniquely positioned to implement “Nutritional Prehabilitation” protocols, monitor for early signs of Immune-Related Adverse Events (irAEs) linked to gut health, and educate patients on the detrimental effects of self-prescribed supplements and processed foods on their microbial ecosystem.
  • Conclusion: Modulating the gut microbiome is no longer an adjunct therapy but a cornerstone of precision oncology. Advanced practice nurses must integrate microbiome assessment into their clinical toolkit. By bridging the gap between molecular immunology and nutritional science, nursing interventions can directly influence the biological landscape of the tumor microenvironment, ultimately improving the survival rates of patients undergoing immunotherapy.
  • Keywords: Gut Microbiome; Cancer Immunotherapy; Immune Checkpoint Inhibitors; Precision Nursing; Nutritional O

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