Understanding Bacterial Roles in Cancer Chemo-resistance: A Signaling Pathway Mapping Study

Introduction: Chemoresistance is one of the leading causes of chemotherapy failure among cancer patients. Out of several hypotheses proposed for chemoresistance, bacteria-mediated chemoresistance to cancer drugs has not been well established. Thus, the aim of this review is to map the pathways by which bacteria exhibit chemoresistance in specific cancers. Material and Methods: Relevant articles on bacteria-mediated chemoresistance in cancer were retrieved by conducting a systematic search across PubMed, Scopus and Web of Science databases. The search was limited to English original articles published until 15th December 2023. Results: A total of nine articles were included to map the pathways involved in chemoresistance. Numerous pathways have been connected to various forms of cancer, such as autophagy pathway in colorectal and esophageal cancers by Fusobacterium nucleatum causing oxaliplatin and 5-FU resistance; DNA damage response pathway also by Fusobacterium nucleatum promoting CDDP resistance in esophageal cancer; Porphyromonas gingivalis led to oral and esophageal cancer resistance to paclitaxel via JAK/STAT pathway. NF-κB pathway involved in gastric cancer in the presence of Helicobacter pylori towards cisplatin, and also 5-FU resistance via the apoptotic pathway. Cellular metabolism modulation by Lactobacillus iners was also implicated in cervical cancer chemoresistance. Conclusion: We conclude that bacteria can mediate chemoresistance not merely to antibiotics but also to anticancer drugs. Thus, a detailed understanding of the pathways associated with chemoresistance mediated via bacteria might help in targeting these pathways or antibiotics to prevent bacterial growth could help overcome resistance.