Cancer cells are continuously evolving to escape the effect of different treatment strategies and it has become a daunting task to control the cancer adoptive nature by various emerging anti-cancer agents. Cancer immunotherapy is a revolutionary approach for the treatment of cancer through harnessing the immune system to get anti-tumour properties. This review summarizes recent trend, advancements of various categories of immunotherapeutic agents, including immune checkpoint inhibitors, cancer vaccines, and adoptive T cell therapies such as CAR T-cell therapy. Immune checkpoint blockade, particularly targeting CTLA-4 and PD-1/PD-L1 pathways, has shown notable success but remains effective in only a subset of patients. Cancer vaccines and neoantigen-targeted approaches are evolving to overcome tumor immune evasion. Adoptive T cell therapies have achieved remarkable outcomes in hematological cancers, though solid tumors pose ongoing challenges. Combination therapies and novel agents offer potential to enhance efficacy and reduce resistance. The review also addresses major hurdles, such as immune-related adverse events and the immunosuppressive tumor microenvironment. Continued research and clinical trials are essential to optimize these therapies and expand their impact, positioning immunotherapy as a vital component of future personalized cancer treatment strategies. This review analysis reflect a paradigm shift toward immune-centric therapies to address unresolved challenges like immune-related toxicity and tumor microenvironment suppression. Keywords: Cancer Immunotherapy; Immune Checkpoint Inhibitors; CAR T - Cell Therapy; Cancer Vaccines; Combination Therapy

References

1. Z Wu., et al. “Global burden of cancer and associated risk factors in 204 countries and territories, 1980-2021: a systematic analysis for the GBD 2021”. Journal of Hematology and Oncology 17 (2024).
2. GD Sepich-Poore., et al. “The microbiome and human cancer”. Science371 (2021).
3. Y Yang., et al. “Fecal microbiota transplantation: no longer cinderella in tumour immunotherapy”. EBioMedicine 100 (2024): 7-9.
4. TM Halsey., et al. “Microbiome alteration via fecal microbiota transplantation is effective for refractory immune checkpoint inhibitor-induced colitis”. Science Translational Medicine 15 (2024).
5. Z Shi., et al. “Emerging roles of the gut microbiota in cancer immunotherapy”. Frontiers in Immunology 14 (2023): 1-13.
6. J Yang., et al. “High-Fat Diet Promotes Colorectal Tumorigenesis Through Modulating Gut Microbiota and Metabolites”. Gastroenterology 162 (2022): 135-149.e2.
7. R He., et al. “Dysbiosis and extraintestinal cancers”. Journal of Experimental and Clinical Cancer Research 44 (2025): 1-21.
8. A Schwan., et al. “Relapsing Clostridium Difficile Enterocolitis Cured By Rectal Infusion of Homologous Faeces”. Lancet 322 (1983): 845.
9. R Singh., et al. “The potential beneficial role of faecal microbiota transplantation in diseases other than Clostridium difficile infection”. European Society of Clinical Microbiology and Infectious Diseases 20 (2014): 1119-1125.
10. C Rajendran., et al. “Durable coexistence of donor and recipient strains after fecal microbiota transplantation”. Science 352 (2016): 583-586.
11. L Fernández., et al. “Phage or foe: An insight into the impact of viral predation on microbial communities”. ISME Journal 12 (2018): 1171-1179.
12. E Meader., et al. “Evaluation of bacteriophage therapy to control clostridium difficile and toxin production in an invitro human colon model system”. Anaerobe 22 (2013): 25-30.
13. K Selle., et al. “Delivered CRISPR-Cas3 Antimicrobials RESULTS”. MBio 11 (2020): 10-1128.
14. JP Zackular., et al. “The gut microbiome modulates colon tumorigenesis”. MBio 4 (2013): 1-9.
15. DJ Lin., et al. “Analysis of influencing factors of washed microbiota transplantation in treating patients with metabolic syndrome”. Frontiers in Nutrition 12 (2025).
16. N Med., et al. “HHS Public Access” 28 (2022): 315-324.
17. Y Ren., et al. “Comparative evaluation of various DNA extraction methods and analysis of DNA degradation levels in commercially marketed Chestnut rose juices and beverages”. BMC Biotechnology 25 (2025): 9.
18. R James and PW. “Cancer, Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients”. Science359 (2018): 97-103.
19. V Matson., et al. “The commensal microbiome is associated with anti-PD-1 efficacy in metastatic melanoma patients”. Science359 (2019): 104-108.
20. EN Baruch., et al. “Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients”. Science 5920 (2020): 1-16.
21. D Davar., et al. “Fecal microbiota transplant overcomes resistance to anti - PD-1 therapy in melanoma patients”. Science 602 (2021): 595-602.
22. L Derosa., et al. “Gut Bacteria Composition Drives Primary Resistance to Cancer Immunotherapy in Renal Cell Carcinoma Patients”. European Urology 78 (2020): 195-206.
23. MC Andrews., et al. “Gut microbiota signatures are associated with toxicity to combined CTLA-4 and PD-1 blockade”. Nature Medicine 27 (2021): 1432-1441.
24. M Santoni., et al. “Re: Gut Microbiome Influences Efficacy of PD-1-based Immunotherapy Against Epithelial Tumors”. European Urology 74 (2018): 521-522.
25. Christopher R John. “350 (2020).
26. A Grenda., et al. “Gut microbial predictors of first-line immunotherapy efficacy in advanced NSCLC patients”. Scientific Reports 15 (2025): 6139.
27. C Zhang., et al. “Gut microbiota in colorectal cancer: a review of its influence on tumor immune surveillance and therapeutic response”. Frontiers in Oncology 15 (2025): 1-15.
28. C Laface., et al. “HCC and Immunotherapy : The Potential Predictive Role of Gut Microbiota and Future Therapeutic Strategies”. Oncology 5 (2025): 1-19.
29. JWC Chang., et al. “Gut microbiota and clinical response to immune checkpoint inhibitor therapy in patients with advanced cancer”. Biomedical Journal 47 (2024): 100698.
30. I Zalila-kolsi., et al. “The Gut Microbiota and Colorectal Cancer : Understanding the Link and Exploring Therapeutic Interventions”. Biology (Basel) 14 (2025).
31. H Jiang and Q Zhang. “Gut microbiota influences the efficiency of immune checkpoint inhibitors by modulating the immune system (Review)”. Oncology Letters 27 (2024): 1-14.
32. J Sun., et al. “Gut microbiota as a new target for anticancer therapy: from mechanism to means of regulation”. Npj Biofilms Microbiomes 11 (2025): 1-20.
33. X Zhao., et al. “Combination of thalidomide and Clostridium butyricum relieves chemotherapy-induced nausea and vomiting via gut microbiota and vagus nerve activity modulation”. Frontiers in Immunology 14 (2023): 1-13.
34. E Dias-Jácome., et al. “Gastric microbiota and carcinogenesis: The role of non-Helicobacter pylori bacteria - A systematic review”. Revista Espanola De Enfermedades Digestivas 108 (2016): 530-540.
35. YY Hsieh., et al. “Increased Abundance of Clostridium and Fusobacterium in Gastric Microbiota of Patients with Gastric Cancer in Taiwan”. Scientific Reports 8 (2018): 1-11.
36. RM Ferreira., et al. “Gastric microbial community profiling reveals a dysbiotic cancer-associated microbiota”. Gut 67 (2018): 226-236.
37. D Chen., et al. “Fecal microbiota transplantation in cancer management: Current status and perspectives”. International Journal of Cancer 145 (2019): 2021-2031.
38. H Tsoi., et al. “Peptostreptococcus anaerobius Induces Intracellular Cholesterol Biosynthesis in Colon Cells to Induce Proliferation and Causes Dysplasia in Mice”. Gastroenterology 152 (2017): 1419-1433.e5.
39. J Yu., et al. “Metagenomic analysis of faecal microbiome as a tool towards targeted non-invasive biomarkers for colorectal cancer”. Gut 66 (2017): 70-78.
40. ZF Chen., et al. “Probiotics Clostridium butyricum and Bacillus subtilis ameliorate intestinal tumorigenesis”. Future Microbiol 10 (2015): 1433-1445.
41. E Jacouton., et al. “Probiotic strain Lactobacillus casei BL23 prevents colitis-associated colorectal cancer”. Frontiers in Immunology 8 (2017): 1-10.
42. S Liang., et al. “Effect of probiotics on small intestinal bacterial overgrowth in patients with gastric and colorectal cancer”. Turkish Journal of Gastroenterology 27 (2016): 227-232.
43. EK Plowman., et al. “This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record”. Please c, Laryngoscope (2014): 2-31.
44. SH Wong., et al. “Gavage of Fecal Samples From Patients With Colorectal Cancer Promotes Intestinal Carcinogenesis in Germ-Free and Conventional Mice”. Gastroenterology 153 (2017): 1621-1633.e6.
45. SP Rosshart., et al. “Wild Mouse Gut Microbiota Promotes Host Fitness and Improves Disease Resistance”. Cell 176 (2017): 139-148.
46. MJ Hill., et al. “Gut Bacteria and Ætiology of Cancer of the Breast”. Lancet 298 (1971): 472-473.
47. JJ Goedert., et al. “Postmenopausal breast cancer and oestrogen associations with the IgA-coated and IgA-noncoated faecal microbiota”. British Journal of Cancer 118 (2018): 471-479.
48. J Yang., et al. “Gastrointestinal microbiome and breast cancer: correlations, mechanisms and potential clinical implications”. Breast Cancer 24 (2017): 220-228.
49. H Maroof., et al. “Lactobacillus acidophilus could modulate the immune response against breast cancer in murine model”. Journal of Clinical Immunology 32 (2012): 1353-1359.
50. A Argyraki., et al. “Potential role of intratumor bacteria in mediating tumor resistance to the chemotherapeutic drug gemcitabine, 2015 IEEE Summer Top. Meet. Ser. SUM 2015. 10 (2018): 1-13.
51. S Bullman., et al. “Analysis of Fusobacterium persistence and antibiotic response in colorectal cancer”. Science 358 (2018): 1443-1448.
52. X Fan., et al. “Abstract 4350: Human oral microbiome and prospective risk for pancreatic cancer: a population based, nested case control study”. Cancer Research 76 (2016): 4350-4350.
53. K Mitsuhashi., et al. “Association of Fusobacterium species in pancreatic cancer tissues with molecular features and prognosis”. Oncotarget 6 (2015): 7209-7220.
54. R MICHA. “The Pancreatic Cancer Microbiome Promotes Oncogenesis by Induction of Innate and Adaptive Immune Suppression”. Physiology and Behavior 176 (2017): 100-106.
55. V Gopalakrishnan., et al. “Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients”. Science11 (2017).
56. A Sivan., et al. “Commensal Bifidobacterium promotes antitumor immunity and facilitates anti-PD-L1 efficacy”. Science 350 (2015): 1084-1089.
57. D Davar., et al. “Fecal microbiota transplant overcomes resistance to anti-PD-1 therapy”. Science 371 (2022): 595-602.
58. J Huang., et al. “Ginseng polysaccharides alter the gut microbiota and kynurenine/tryptophan ratio, potentiating the antitumour effect of antiprogrammed cell death 1/programmed cell death ligand 1 (anti-PD-1/PD-L1): immunotherapy”. Gut 71 (2022): 734-745.
59. H Malhi and M Camilleri. “Modulating bile acid pathways and TGR5 receptors for treating liver and GI diseases”. Current Opinion in Pharmacology 37 (2017): 80-86.
60. C Ma., et al. “Gut microbiome-mediated bile acid metabolism regulates liver cancer via NKT cells”. Science 360 (2019): 1-23.
61. S De Minicis., et al. “Dysbiosis contributes to fibrogenesis in the course of chronic liver injury in mice”. Hepatology 59 (2014): 1738-1749.
62. M Llopis., et al. “Intestinal microbiota contributes to individual susceptibility to alcoholic liver disease”. Gut 65 (2016): 830-839.
63. C Qin., et al. “Microbiota transplantation reveals beneficial impact of berberine on hepatotoxicity by improving gut homeostasis”. Science China Life Sciences 61 (2018): 1537-1544.
64. RK Dhiman., et al. “Probiotic VSL#3 reduces liver disease severity and hospitalization in patients with cirrhosis: A randomized, controlled trial”. Gastroenterology 147 (2014): 1327-1337.e3.
65. SH Han., et al. “Effects of probiotics (cultured Lactobacillus subtilis/ Streptococcus faecium): in the treatment of alcoholic hepatitis: Randomized-controlled multicenter study”. European Journal of Gastroenterology and Hepatology 27 (2015): 1300-1306.
66. D Zhou., et al. “Total fecal microbiota transplantation alleviates high-fat diet-induced steatohepatitis in mice via beneficial regulation of gut microbiota”. Scientific Reports 7 (2017): 1-11.
67. G Ferrere., et al. “Fecal microbiota manipulation prevents dysbiosis and alcohol-induced liver injury in mice”. Journal of Hepatology 66 (2017): 806-815.
68. CA Philips., et al. “Healthy Donor Fecal Microbiota Transplantation in Steroid-Ineligible Severe Alcoholic Hepatitis: A Pilot Study”. Clinical Gastroenterology and Hepatology 15 (2017): 600-602.
69. YD Ren., et al. “Fecal microbiota transplantation induces hepatitis B virus e-antigen (HBeAg): clearance in patients with positive HBeAg after long-term antiviral therapy”. Hepatology 65 (2017): 1765-1768.
70. M Klingenberg., et al. “Ernst, The lncRNA CASC9 and RNA binding protein HNRNPL form a complex and co-regulate genes linked to AKT signaling”. Hepatology 777 (2017): 1-36.
71. WW Wang., et al. “Fecal microbiota transplantation prevents hepatic encephalopathy in rats with carbon tetrachloride-induced acute hepatic dysfunction”. World Journal of Gastroenterology 23 (2017): 6983-6994.
72. JS Bajaj., et al. “Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial”. Hepatology 66 (2017): 1727-1738.

Citation

Citation: Sanjay S Gottipamula and Murugesan S. “Emerging Trends and Evolving Landscape in Cancer Immunotherapy”.Acta Scientific Cancer Biology 9.3 (2025): 26-42.

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Copyright: © 2025 Sanjay S Gottipamula and Murugesan S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.