Clinical Report: Comparative Analysis of Gut Microbiome Profiles in HCC Patients

Overview

This systematic review and meta-analysis investigates the gut microbiome differences in hepatocellular carcinoma (HCC) patients undergoing immune checkpoint inhibitor (ICI) therapy. Key findings indicate distinct microbial profiles associated with treatment response.

Background

Hepatocellular carcinoma (HCC) is a prevalent malignancy with significant morbidity and mortality. The advent of immune checkpoint inhibitors (ICIs) has transformed treatment paradigms, yet response rates vary widely among patients. Understanding the role of gut microbiota in influencing treatment outcomes is an area of ongoing research.

Data Highlights

Key Findings

• Beta diversity significantly differed in over 68% of studies analyzed.
• Alpha diversity indices did not show significant differences between responders and non-responders.
• Actinobacteriota was enriched among responders, while Bacteroides was depleted in non-responders.
• Specific taxa such as Collinsella and Ruminococcus were linked to lower mortality risk.
• Taxa associated with worse overall survival included Bacteroides.AF20_13LB and Veillonella atypica.
• Distinct microbial pathways were enriched in responders compared to non-responders.

Clinical Implications

The findings indicate differences in gut microbiome composition between responders and non-responders to ICI therapy in HCC patients.

Conclusion

This study highlights the significant differences in gut microbiome profiles between HCC patients responding and not responding to ICI therapy.

Related Resources & Content

1. Frontiers in Immunology, 2026 -- Functional convergence amid taxonomic variability in gut microbiome–immune checkpoint inhibitor research: a bibliometric and mechanistic synthesis
2. Hepatocellular carcinoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up, 2026
3. FDA, 2025 -- FDA approves nivolumab with ipilimumab for unresectable or metastatic hepatocellular carcinoma
4. the asco post — Gut Microbiome Differs in Responders and Nonresponders to Immune Checkpoint Inhibitors in Patients With HCC
5. the asco post — Immune Checkpoint Inhibitors for Patients With Child-Pugh Class B vs A Advanced Hepatocellular Carcinoma
6. the asco post — Association Between Pathologic Response and Relapse-Free Survival With Neoadjuvant Immune Checkpoint Inhibitor Therapy for Hepatocellular Carcinoma
7. Gut Microbiome Differs in Responders and Nonresponders to Immune Checkpoint Inhibitors in Patients With HCC
8. Immune Checkpoint Inhibitors for Patients With Child-Pugh Class B vs A Advanced Hepatocellular Carcinoma
9. Association Between Pathologic Response and Relapse-Free Survival With Neoadjuvant Immune Checkpoint Inhibitor Therapy for Hepatocellular Carcinoma
10. Hepatocellular carcinoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up☆
11. FDA approves nivolumab with ipilimumab for unresectable or metastatic hepatocellular carcinoma | FDA
12. Frontiers | Gut Microbiota Composition in Responders versus Non-Responders with Hepatocellular Carcinoma Under ICI Therapy: A Systematic Review and Meta-Analysis