Use, understanding, and perceptions of gut microbiome research and practices in oncology

Purpose: The gut microbiome has gained increasing recognition as an important factor influencing cancer treatment efficacy and toxicity. However, translation of this knowledge to deliver clinical benefit has been hampered by inconsistent approaches to both biospecimen sampling and investigation of microbial-based interventions, potentially reflecting inherent biases and/or barriers across research environments. Accordingly, we aimed to characterize the current practices and perceptions surrounding the gut microbiome among members of the Multinational Association of Supportive Care in Cancer (MASCC). Methods: A mixed-methods survey, probing current research and/or clinical use, plans, and perceptions of the gut microbiome in oncology, was developed in 2022 and distributed MASCC-wide via REDCap. Quantitative data were summarized using descriptive analyses, and qualitative responses were independently dual-coded using inductive thematic analysis. Results: Out of 117 respondents, the majority (83%) held the belief that the gut microbiome plays an important role in disease states such as cancer. 44.4% of survey respondents reported ongoing research or clinical practice regarding the gut microbiome at their center, with 70.5% also expressing an interest in developing such a program. Qualitative analysis revealed 6 main themes: (1) state of the evidence, (2) significance of the microbiome, (3) uncertainty, (4) aspirations, (5) preferences, and (6) critique. Conclusions: This survey identifies general concordance on the importance of the gut microbiome in cancer. Despite interest in this field, there is a clear need for resource support (i.e., funding and infrastructure) and increased expertise to support high-quality trials generating the evidence required for implementation of microbial-based sampling or therapeutics in clinical practice.