Gut Microbiota in Lung Cancer: Prognostic Insights and Therapeutic Opportunities

The gut microbiota has emerged as a critical determinant of systemic immune homeostasis, inflammation, and metabolic regulation, with growing relevance in cancer biology and treatment responsiveness. In lung cancer, accumulating evidence indicates that the intestinal microbiome may significantly influence disease progression, therapeutic efficacy, and clinical outcomes through its capacity to modulate host immunity, inflammatory signalling, and treatment-related toxicity. Variations in microbial composition, diversity, and metabolite production have been associated with differential responses to immune checkpoint blockade, targeted therapies, and combination regimens, suggesting that the gut microbiota may serve as both a prognostic and predictive biomarker in thoracic oncology.Nevertheless, the biological and translational framework linking the gut microbiota to lung cancer remains incompletely defined. Important questions persist regarding the molecular mechanisms underlying the gut-lung axis, the contribution of dysbiosis to treatment resistance, and the extent to which host-related variables, such as antibiotic exposure, dietary habits, metabolic status, and comorbidities, shape microbiota-dependent therapeutic responses. In parallel, microbiota-targeted interventions, including fecal microbiota transplantation (FMT), probiotics, prebiotics, postbiotics, and dietary modulation, are gaining attention as innovative strategies to restore microbial homeostasis, enhance anti-tumor immunity, and improve sensitivity to current therapies. However, the field still requires mechanistic validation, standardized analytical approaches, and clinically robust evidence to enable translation into precision oncology.This Research Topic aims to provide a comprehensive and mechanistically oriented overview of the role of gut microbiota in lung cancer, with particular emphasis on prognostic stratification, treatment response, and therapeutic intervention. Its main objectives are to elucidate how gut microbial ecosystems and their functional outputs shape tumor biology and systemic anti-cancer immunity; to identify microbiome-based biomarkers associated with benefit, resistance, or toxicity in patients receiving immunotherapy or targeted therapies; and to explore emerging microbiota-modulating strategies with potential clinical relevance. By integrating preclinical, translational, and clinical perspectives, this collection seeks to advance microbiome-informed approaches that may ultimately support more personalized and effective treatment paradigms in lung cancer.The Scope of this Research Topic encompasses both fundamental and translational studies, with a focus on contributions delivering mechanistic validation, clinically meaningful biomarker discovery, or innovative therapeutic strategies centered on microbiota modulation in lung cancer. We welcome submissions addressing, but not limited to, the following themes:• Gut microbiota composition, diversity, and functional signatures as prognostic and predictive biomarkers in lung cancer• Molecular and immunological mechanisms of gut-lung axis communication in tumor progression and therapeutic response• Microbiota-driven determinants of sensitivity or resistance to immune checkpoint inhibitors• Interactions between gut microbiota and targeted therapies, including tyrosine kinase inhibitors and combination regimens• Role of dysbiosis, antibiotic exposure, diet, comorbidities, and host metabolism in shaping treatment outcomes• Multi-omics strategies integrating metagenomics, metabolomics, transcriptomics, and immune profiling for biomarker discovery• Fecal microbiota transplantation (FMT), probiotics, prebiotics, postbiotics, and dietary interventions as microbiota-modulating approaches in lung cancer• Translational and clinical frameworks for incorporating microbiome-informed strategies into precision thoracic oncology Topic editors: Lorenzo Belluomini, Lisa DEROSA Source: https://www.frontiersin.org/research-topics/80511/gut-microbiota-in-lung-cancer-prognostic-insights-and-therapeutic-opportunities