Imperial College London

Emeritus ProfessorJeremyNicholson

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Emeritus Professor of Biological Chemistry



+44 (0)20 7594 3195j.nicholson Website




Ms Wendy Torto +44 (0)20 7594 3225




Office no. 665Sir Alexander Fleming BuildingSouth Kensington Campus






BibTex format

author = {Alexander, JL and Wilson, ID and Teare, J and Marchesi, JR and Nicholson, JK and Kinross, JM},
doi = {10.1038/nrgastro.2017.20},
journal = {Nature Reviews Gastroenterology and Hepatology},
pages = {356--365},
title = {Gut microbiota modulation of chemotherapy efficacy and toxicity.},
url = {},
volume = {14},
year = {2017}

RIS format (EndNote, RefMan)

AB - Evidence is growing that the gut microbiota modulates the host response to chemotherapeutic drugs, with three main clinical outcomes: facilitation of drug efficacy; abrogation and compromise of anticancer effects; and mediation of toxicity. The implication is that gut microbiota are critical to the development of personalized cancer treatment strategies and, therefore, a greater insight into prokaryotic co-metabolism of chemotherapeutic drugs is now required. This thinking is based on evidence from human, animal and in vitro studies that gut bacteria are intimately linked to the pharmacological effects of chemotherapies (5-fluorouracil, cyclophosphamide, irinotecan, oxaliplatin, gemcitabine, methotrexate) and novel targeted immunotherapies such as anti-PD-L1 and anti-CLTA-4 therapies. The gut microbiota modulate these agents through key mechanisms, structured as the 'TIMER' mechanistic framework: Translocation, Immunomodulation, Metabolism, Enzymatic degradation, and Reduced diversity and ecological variation. The gut microbiota can now, therefore, be targeted to improve efficacy and reduce the toxicity of current chemotherapy agents. In this Review, we outline the implications of pharmacomicrobiomics in cancer therapeutics and define how the microbiota might be modified in clinical practice to improve efficacy and reduce the toxic burden of these compounds.
AU - Alexander,JL
AU - Wilson,ID
AU - Teare,J
AU - Marchesi,JR
AU - Nicholson,JK
AU - Kinross,JM
DO - 10.1038/nrgastro.2017.20
EP - 365
PY - 2017///
SN - 1759-5045
SP - 356
TI - Gut microbiota modulation of chemotherapy efficacy and toxicity.
T2 - Nature Reviews Gastroenterology and Hepatology
UR -
UR -
UR -
UR -
VL - 14
ER -