Fecal microbiota transplantation as a novel therapeutic strategy for pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive cancers with limited treatment options and a poor prognosis. Recent studies have emphasized the pivotal influence of the microbiome, particularly intratumoral and gut microbial systems, in driving PDAC progression and shaping therapeutic responses. Emerging strategies for microbiome modulation, such as fecal microbiota transplantation (FMT), have demonstrated the potential in preclinical models to enhance immune responses and inhibit tumor growth. However, significant challenges including donor variability, microbiome engraftment, and suboptimal delivery methods have hindered the transition of these strategies to clinical settings. Addressing these limitations by optimizing microbiota-based therapies is essential for harnessing their full potential as adjunct treatments for PDAC. This review delves into the intricate relationship between microbiota and PDAC, evaluates the therapeutic efficacy and limitations of FMT, and outlines future research trajectories to advance this emerging field.