Subclinical cholestasis is a hallmark of gut dysbiosis causing resistance to cancer immunotherapy

Gut dysbiosis drives resistance to cancer immunotherapy in tumors distant from the gastrointestinal tract by inducing subclinical cholestasis via the gut-liver axis. Mallard de La Varende et al. showed that dysbiosis elevates plasma γ-glutamyl transferase, increases taurochenodeoxycholic acid (TCDCA in humans, TMCA in mice), and reduces soluble MAdCAM-1 levels, collectively impairing tumor immunosurveillance. The findings identify a mechanistic link between gut microbiome disruption and systemic immunotherapy failure, suggesting that monitoring liver-related biomarkers could help predict treatment resistance.