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Research links gut dysbiosis to pancreatic cancer, offering opportunities for early diagnosis
Last reviewed: 02.07.2025
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A new study examines the role of gut microbiota in the diagnosis and treatment of pancreatic cancer, raising hopes for innovative screening and treatment methods.
A recent review in Cancer Screening and Prevention examines how the gut microbiome influences immunity, metabolism, and the tumor environment in pancreatic ductal adenocarcinoma (PDAC), one of the cancers with the highest mortality rate.
The review highlights gut microbiome-based cancer control strategies, the potential for early screening of PDAC using microbial markers, and the prospects of faecal microbial transplantation (FMT) as a future treatment option. Challenges in gut microbiome research are also discussed and ways to address them are proposed.
Pancreatic ductal adenocarcinoma (PDAC), the most common and severe type of pancreatic cancer, accounts for more than 80% of cases and results in more than 446,000 deaths each year.
Despite advances in treatment, the five-year survival rate for PDAC is only 10%, and nearly 90% of patients die within a year due to late detection. Only 15–20% of cases are amenable to surgical removal at diagnosis.
Growing interest in the role of diet and gut microbiota in chronic diseases has stimulated metagenomic studies exploring microbial markers for early cancer detection and potential treatment.
Fecal Microbiota Transplantation and Gut Dysbiosis in PDAC
Fecal microbiota transplant (FMT) is an ancient but poorly understood medical procedure in which beneficial microbiota from the stool of a healthy donor are transferred into a patient's digestive tract.
First described in Traditional Chinese Medicine (c. 300 CE), FMT was long ignored in Western medicine due to concerns about its safety and effectiveness.
Recently, interest in FMT has been revived due to growing evidence of its ability to enhance the effectiveness of chemotherapy and mitigate adverse reactions to chemotherapy.
However, the mechanisms underlying the benefits of FMT remain largely unknown. Comparisons of gut microbial compositions between healthy individuals and PDAC patients using RNA sequencing and metagenomic characterization have revealed significant differences, with PDAC patients showing increased populations of Streptococcus and Veillonella and a significant decrease in Faecalibacterium species. Studies also point to the role of Helicobacter pylori infection, which is associated with an increased risk of PDAC.
Gut microbial assemblages vary considerably among people of different ethnic and geographic groups, and even siblings may have differences in microbiota composition.
This high variability makes it difficult to standardize diagnostic procedures based on microbial markers and complicates studies based on FMT results.
Encouragingly, the advent of machine learning algorithms and the development of high-throughput "next generation" technologies have enabled the creation of several faecal metagenomic classifiers capable of detecting PDAC significantly earlier than traditional screening methods.
Metabolomics and the Potential of FMT in PDAC Treatment
Metabolites produced during growth play a key role in diseases such as cancer. Metabolomic studies show that butyric acid produced by bacteria can promote differentiation of PDAC cells and reduce their invasiveness.
Patients with PDAC have a deficiency of butyric acid-producing bacteria and low levels of butyric acid, as well as indole-3-acetic acid, which promotes chemotherapy. Correcting gut metabolite levels by altering the microbial composition may improve PDAC outcomes, as gut health influences the effectiveness of systemic therapy. Notably, PDAC patients treated with antibiotics often have poorer survival.
Future research aims to explore the role of gut microbiota in supporting PDAC treatment, with faecal microbiota transplantation (FMT) seen as a promising approach. Although animal studies show the potential of FMT to slow tumor growth and improve survival, human clinical trials carry risks such as antibiotic-resistant infections, highlighting the need for careful donor selection and monitoring.
Gut microbiota characterization and microbiome-based interventions (e.g., FMT) show significant potential to accelerate PDAC detection (early screening) and reduce disease severity. Although this is a relatively new area of clinical research, continued advances in metagenomic sequencing technologies and metabolomic models may revolutionize PDAC treatment in the future.
However, precautions must be taken to ensure sufficient and regular donor selection and follow-up of PDAC patients to prevent complications that have previously arisen in human clinical trials.