SynthesisWorld journal of urology2026
Gut microbiome impact on systemic therapy outcomes in metastatic renal cell carcinoma: a systematic review.
Synthesis in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Comment on "Gut microbiome impact on systemic therapy outcomes in metastatic renal cell carcinoma: a systematic review" by Gavi et al.World journal of urology · 2026Article
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20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveMetastatic renal cell carcinoma (mRCC) treatment with immune checkpoint inhibitors (ICIs) and vascular endothelial growth factor–tyrosine kinase inhibitors (VEGF-TKIs) yields durable benefit in a subset of patients, yet primary resistance remains frequent. Emerging data implicate the gut microbiome as a determining factor of systemic therapy efficacy. This review systematically evaluates clinical evidence on antibiotics (ATBs), probiotics, dietary interventions, and fecal microbiota transplantation (FMT) in modulating the gut microbiome to influence outcomes in adult patients with mRCC.
methodsEligible studies included adult (≥ 18 year) RCC cohorts receiving microbiome interventions versus standard care, reporting objective response rate (ORR), progression-free survival (PFS), overall survival (OS), or immune-related adverse events (irAEs). KEY FINDINGS AND LIMITATIONS: Six studies (N = 4738) met criteria: three retrospective cohorts linking peri-ICI ATB exposure to inferior ORR (12.9–34.8%), shorter PFS (hazard ratios [HR] 1.96–3.10), and OS (HR 3.5); one prospective RCT (n = 20) demonstrating engraftment of Bifidobacterium animalis yogurt during VEGF-TKI therapy with enrichment of Akkermansia muciniphila and trends to longer PFS; and one phase II RCT abstract (n = 50) showing FMT from an ICI responder improved 1-year PFS (66.7% vs. 35.0%, p = 0.036) and ORR (54% vs. 28%) in pembrolizumab + axitinib recipients. CONCLUSIONS AND CLINICAL IMPLICATIONS: ATB-induced dysbiosis compromises ICI efficacy in mRCC; probiotics and FMT exhibit promise to augment immunotherapy and targeted therapy. Prospective, biomarker-driven RCTs with standardized microbiome assays are needed before routine clinical implementation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.