Antitumor mechanism of traditional Chinese medicine: a review of gut microbiota-mediated immunotherapy

OBJECTIVES: Traditional Chinese Medicine (TCM) has garnered significant interest for its role in modulating gut microbiota to inhibit tumor progression. This review aims to systematically elucidate the mechanistic basis for TCM-mediated antitumor activity via gut microbiota modulation. Based on the microbiota-immune axis theory, it also intends to investigate the optimizing effects of TCM on traditional tumor treatment modalities. By establishing a theoretical foundation for the role of TCM in microbiota-mediated immunotherapy, this review also provides evidence supporting its multi-target and cross-organ antitumor properties. METHODS: All the information was collected through library searches and scientific databases. KEY FINDINGS: Gut microbiota dysbiosis promotes tumors not only in the digestive system but also beyond it, via gut-organ-axis signaling and metabolic mechanisms. TCM modulates host immunity both through gut microbiota remodeling and microbial metabolite-mediated activation of immune cells. Similarly, via the gut microbiota, TCM can reduce toxicity and enhance the efficacy of conventional cancer therapies. During TCM treatment, as the gut microbiota undergoes dynamic succession, its regulatory effect on the host immune system exhibits corresponding time-dependent changes. CONCLUSIONS: Research on gut microbiota-mediated TCM immunotherapy demonstrates the theoretical basis for TCM's trans-organ antitumor effects.