Anticancer immunotherapy is a promising approach to the treatment of
cancer. Probiotics have been introduced as a potential candidate to contribute to the
success of the anticancer immunotherapy approach. However, current and future
challenges in probiotics-based anticancer immunotherapy should be addressed to allow
better utilization and understanding of the limitations of the use of probiotics in such an
approach. This chapter highlights the safety issues related to probiotics use in human
subjects, such as adverse effects, bacteremia and risk-benefits analysis. It also briefly
discusses the status of the use of probiotics in human clinical trials to assess the
therapeutic effects of probiotics in the anticancer immunotherapy approach. More
human clinical trials are needed and should follow the principles of Good Clinical
Practice (GCP), with methodologies and end-points, useful to define outcomes by
considering their physiological and clinical meaning. Challenges related to the
properties of different probiotic species, their viability, and their strain-specific
therapeutic effects have been highlighted. It also spotlights the contemporary state of
personalized treatment for cancer patients using selected probiotic strains individually
and/or in combination. Careful consideration should be given to these issues in the use
of probiotic supplements in anticancer immunotherapy in clinical practice in the future.
Keywords: Anticancer, Artificial intelligence (AI), Adverse effects, Bacteremia, Clinical trials, Cancer, Flora, Gut, Immunotherapy, Microbiome, Probiotics, Personalized probiotics, Safety, Smart probiotics, Strains, Therapeutic effects, Viability.