# Critical role of reproductive tract microbiota and derived metabolites in inflammation, tumor immunity, and tumorigenesis of gynecological cancers: a narrative review

## TL;DR

This review explores how the microbiome and its metabolites influence gynecological cancers, offering new insights for treatment and diagnosis.

## Contribution

The paper provides a comprehensive overview of how gut and reproductive tract microbiota affect gynecological cancer progression and treatment through immune and metabolic mechanisms.

## Key findings

- Microbial metabolites like short-chain fatty acids and bile acids influence tumor immunity and treatment resistance.
- Microbiome-targeted interventions show promise for improving diagnosis and treatment of gynecological cancers.
- The microbiota-reproductive axis offers novel strategies to overcome therapeutic resistance in gynecologic oncology.

## Abstract

Gynecological malignancies, including ovarian, cervical, and endometrial cancers, present significant clinical challenges due to the epidemiological complexity and limitations in current therapeutic strategies. Emerging evidence highlights the critical role of the microbiome and its metabolites in modulating tumor initiation, progression, and treatment responses. This review explores the intricate mechanisms through which gut and reproductive tract microbiota influence gynecological cancers via immune regulation, metabolic reprogramming, and epigenetic modifications. Key microbial metabolites, such as short-chain fatty acids, bile acids, and estrogen-metabolizing intermediates, serve as molecular bridges in host-microbe communication, impacting chemotherapy resistance and immunotherapy efficacy. Furthermore, we discuss the translational potential of microbiome-targeted interventions, including probiotics, fecal microbiota transplantation, and precision microbial therapies, as innovative approaches for diagnosis, prognosis, and treatment. Understanding the microbiota-reproductive axis offers novel insights into overcoming therapeutic resistance and improving patient outcomes in gynecologic oncology.