A new review article has been published in Cells, exploring the intricate relationship between the vaginal microbiota and the ovarian cancer microenvironment—a rapidly emerging topic in gynecologic oncology.
This work involved the MicroModenaLab (UNIMORE), the University of Modena, the University of Sassari, the University of Parma, the University of Napoli “Federico II”, the University of Trieste, the IRCCS National Cancer Institute of Milan, the IRCCS National Cancer Institute “G. Pascale” of Naples, the “Gaetano Marino” University Hospital of Messina, and the Temple University (Philadelphia, USA).
ABSTRACT
Background: The tumor microenvironment offers a new perspective in gynecologic on- cology. In ovarian cancer, numerous preclinical studies, especially organoid models, have highlighted cellular, immune, and biochemical mechanisms. Beyond these sophisticated findings, more practical aspects require attention, such as the role of vaginal microbiota, which represents an interplay between external agents and internal genitalia, and its poten- tial profiling role in early detection beyond the promise of microbiota-targeted therapies. Objectives: This review aims to assess whether such a correlation is speculative or scientifi- cally grounded. Methods: A focused literature search was conducted on vaginal microbiota and its correlation with ovarian cancer to define the current state of knowledge. Results: Mixed outcomes have been reported, yet there is a rational and scientific basis supporting further investigation. Clinical approaches increasingly consider vaginal microbiota as relevant. However, we have to say that most available evidence is still preliminary and largely preclinical to set realistic expectations for readers. Although additional studies are needed, emerging insights highlight its importance and practical implications. We present a diagnostic–therapeutic management flowchart summarizing current evidence). Discussion: Most links between the vaginal microbiota and ovarian cancer are correlational rather than causal. The idea that microbes ascend from the vagina to the ovaries is pro- posed but still definitely not demonstrated. Confounding factors like age, hormones, and BRCA status complicate interpretation, and ovarian cancer itself could secondarily alter the microbiota. Mechanistic studies and longitudinal data are still needed to clarify whether dysbiosis contributes to carcinogenesis or is merely a consequence. As gynecologists, we summarize key aspects and emphasize to colleagues the importance of incorporating these findings into daily clinical practice. Vaginal dysbiosis should be considered not only a local imbalance but also a potential strategy for primary cancer prevention. Conclusions: Future research on the tumor microenvironment and vaginal microbiota will expand scientific knowledge and guide innovative preventive and therapeutic strategies.
See the full text at: https://www.mdpi.com/2073-4409/14/20/1590