Title: Effect of probiotics combined with immune checkpoint suppressors and chemotherapeutic
agents on digestive system function, intestinal immunity and prognosis in patients with
metastatic colorectal carcinoma: a quasi-experimental study
Version: 0 Date: 21 Dec 2024
Reviewer's report:
This study presents a significant investigation into the potential benefits of combining
probiotics with immune checkpoint inhibitors and chemotherapeutic agents for patients with
metastatic colorectal carcinoma. By examining outcomes such as survival rates, immune
function, intestinal flora balance, and quality of life, the authors provide valuable insights
into the therapeutic potential of this combination strategy. However, some points merit further
consideration:
1. The study emphasizes the benefits of probiotics in reducing chemotherapy-associated
toxicities and improving immune parameters. Could additional data on the therapeutic effects
and potential toxicities of these treatments, beyond the initial two-year follow-up period, provide
a more comprehensive understanding of long-term outcomes?
2. The reliance on a single hospital cohort may limit the generalizability of the findings.
Would including additional cases from diverse demographic and geographic settings enhance
the robustness and applicability of the conclusions?
3. While the results highlight a significant improvement in intestinal flora and immune
markers, the mechanisms underlying these changes remain insufficiently explored. Could further
molecular analyses, such as metagenomic sequencing or cytokine profiling, clarify the causal
pathways and strengthen the study's conclusions?
4. The quality-of-life data demonstrate noticeable improvement in the study group, yet the
underlying factors driving these enhancements are not fully dissected. Would including patient-
reported outcomes and detailed psychological assessments provide a deeper understanding of
these observations?
5. The study mentions that probiotics may regulate immune function via T-cell modulation.
Could additional experiments or analyses, such as ex vivo immune cell studies or cytokine
quantifications, validate these findings and provide mechanistic insights?
6. The paper acknowledges limitations related to sample size and study scope. A more detailed
discussion of potential confounding factors, such as dietary patterns or concurrent medications,
would provide clarity on how these variables might influence the observed results.
7. The chosen probiotic formulation includes multiple bacterial strains. Could a breakdown
of the individual contributions of each strain to the observed effects help refine therapeutic
strategies?
Title: Effect of probiotics combined with immune checkpoint suppressors and chemotherapeutic
agents on digestive system function, intestinal immunity and prognosis in patients with
metastatic colorectal carcinoma: a quasi-experimental study
Version: 0 Date: 21 Dec 2024
Reviewer's report:
This study presents a significant investigation into the potential benefits of combining
probiotics with immune checkpoint inhibitors and chemotherapeutic agents for patients with
metastatic colorectal carcinoma. By examining outcomes such as survival rates, immune
function, intestinal flora balance, and quality of life, the authors provide valuable insights
into the therapeutic potential of this combination strategy. However, some points merit further
consideration:
1. The study emphasizes the benefits of probiotics in reducing chemotherapy-associated
toxicities and improving immune parameters. Could additional data on the therapeutic effects
and potential toxicities of these treatments, beyond the initial two-year follow-up period, provide
a more comprehensive understanding of long-term outcomes?
2. The reliance on a single hospital cohort may limit the generalizability of the findings.
Would including additional cases from diverse demographic and geographic settings enhance
the robustness and applicability of the conclusions?
3. While the results highlight a significant improvement in intestinal flora and immune
markers, the mechanisms underlying these changes remain insufficiently explored. Could further
molecular analyses, such as metagenomic sequencing or cytokine profiling, clarify the causal
pathways and strengthen the study's conclusions?
4. The quality-of-life data demonstrate noticeable improvement in the study group, yet the
underlying factors driving these enhancements are not fully dissected. Would including patient-
reported outcomes and detailed psychological assessments provide a deeper understanding of
these observations?
5. The study mentions that probiotics may regulate immune function via T-cell modulation.
Could additional experiments or analyses, such as ex vivo immune cell studies or cytokine
quantifications, validate these findings and provide mechanistic insights?
6. The paper acknowledges limitations related to sample size and study scope. A more detailed
discussion of potential confounding factors, such as dietary patterns or concurrent medications,
would provide clarity on how these variables might influence the observed results.
7. The chosen probiotic formulation includes multiple bacterial strains. Could a breakdown
of the individual contributions of each strain to the observed effects help refine therapeutic
strategies?
Please review this paper.
user
Title: Effect of probiotics combined with immune checkpoint suppressors and chemotherapeutic
agents on digestive system function, intestinal immunity and prognosis in patients with
metastatic colorectal carcinoma: a quasi-experimental study
Version: 0 Date: 21 Dec 2024
Reviewer's report:
This study presents a significant investigation into the potential benefits of combining
probiotics with immune checkpoint inhibitors and chemotherapeutic agents for patients with
metastatic colorectal carcinoma. By examining outcomes such as survival rates, immune
function, intestinal flora balance, and quality of life, the authors provide valuable insights
into the therapeutic potential of this combination strategy. However, some points merit further
consideration:
1. The study emphasizes the benefits of probiotics in reducing chemotherapy-associated
toxicities and improving immune parameters. Could additional data on the therapeutic effects
and potential toxicities of these treatments, beyond the initial two-year follow-up period, provide
a more comprehensive understanding of long-term outcomes?
2. The reliance on a single hospital cohort may limit the generalizability of the findings.
Would including additional cases from diverse demographic and geographic settings enhance
the robustness and applicability of the conclusions?
3. While the results highlight a significant improvement in intestinal flora and immune
markers, the mechanisms underlying these changes remain insufficiently explored. Could further
molecular analyses, such as metagenomic sequencing or cytokine profiling, clarify the causal
pathways and strengthen the study's conclusions?
4. The quality-of-life data demonstrate noticeable improvement in the study group, yet the
underlying factors driving these enhancements are not fully dissected. Would including patient-
reported outcomes and detailed psychological assessments provide a deeper understanding of
these observations?
5. The study mentions that probiotics may regulate immune function via T-cell modulation.
Could additional experiments or analyses, such as ex vivo immune cell studies or cytokine
quantifications, validate these findings and provide mechanistic insights?
6. The paper acknowledges limitations related to sample size and study scope. A more detailed
discussion of potential confounding factors, such as dietary patterns or concurrent medications,
would provide clarity on how these variables might influence the observed results.
7. The chosen probiotic formulation includes multiple bacterial strains. Could a breakdown
of the individual contributions of each strain to the observed effects help refine therapeutic
strategies?
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