Microbiome-Modifiers for Cancer-Related Fatigue Management: A Systematic Review

Objectives: This study systematically investigates the evidence regarding the use of probiotics in managing cancer-related fatigue (CRF). Study Design: We conducted a systematic review of randomized controlled trials. Data Sources: The systematic search encompassed six databases: PubMed, CINHAL, Cochrane Database of Sys- tematic Reviews, Web of Science, Scopus, and EMBASE, covering the period from inception to December 2023. The assessment of risk of bias employed the Cochrane risk of bias tool (RoB 2). A narrative synthesis and an exploratory meta-analysis were conducted to summarize the evidence. Results: Among 460 records, three studies met the eligibility criteria and were included in the review. These studies involved a total of 284 participants with colorectal and breast cancer. One study demonstrated a mar- ginal improvement in CRF postchemotherapy in colorectal cancer patients using probiotics. Another study, also using probiotics, reported a significant reduction in CRF among colorectal cancer patients undergoing chemotherapy. Additionally, a study employing synbiotics showed a substantial decrease in CRF severity in breast cancer patients receiving chemotherapy. Conclusion: The study presents initial but varied evidence suggesting the potential of probiotics and synbiot- ics as adjunctive therapies in managing CRF alongside anticancer treatments. Implications for Nursing Practice: In nursing practice, large-scale clinical trials are urgently needed to evaluate the effectiveness of probiotics in treating cancer-related fatigue during cancer therapy. Insights from this review could guide nurses in selecting appropriate probiotic strains and integrating microbiome modifiers into comprehensive care plans, potentially enhancing the quality of life for cancer patients.