The microbiota is now recognized as one of the major players in human health and diseases, including cancer. Regarding breast cancer (BC), a clear link between microbiota and oncogenesis still needs to be confirmed. Yet, part of the bacterial gene mass inside the gut, constituting the so called “estrobolome”, influences sexual hormonal balance and, since the increased exposure to estrogens is associated with an increased risk, may impact on the onset, progression, and treatment of hormonal dependent cancers (which account for more than 70% of all BCs). The hormonal dependent BCs are also affected by environmental and dietary endocrine disruptors and phytoestrogens which interact with microbiota in a bidirectional way: on the one side disruptors can alter the composition and functions of the estrobolome, ad on the other the gut microbiota influences the metabolism of endocrine active food components. This review highlights the current evidence about the complex interplay between endocrine disruptors, phytoestrogens, microbiome, and BC, within the frames of a new “oncobiotic” perspective.

In this review we focused on the assessment of malnutrition risk in patients with pancreatic cancer (PaC), emphasizing its relationships with patients’ characteristics and clinical outcomes. Despite the profound impact of PaC and its treatments on nutritional status, malnutrition risk in PaC patients has received less attention than it deserves, and the use of screening tools in clinical practice remains inconsistent. We conducted literature searches in PubMed, Scopus, and Web of Science. Full-text searches combined the terms “malnutrition AND risk” or “nutritional AND risk” or “nutritional screening” or “malnutrition screening” with “pancreatic OR pancreas.” A variety of screening tools have been applied in PaC patients, primarily before curative surgery. Reported prevalence of malnutrition risk varied widely, and higher risk was consistently associated with adverse short- and long-term outcomes, including post-operative complications, longer hospital stay, poor tolerance to chemotherapy, and reduced survival. Comparative studies evaluating the reliability and prognostic performance of different tools remain limited. Further evidence is needed to define optimal approaches for assessing malnutrition risk in PaC patients, to evaluate the impact of nutritional interventions, and to integrate malnutrition screening into standard nutritional care protocols. Future studies should focus on identifying optimal risk cut-off values, monitoring changes in nutritional risk over the course of disease, and determining the most reliable tools for different clinical settings.

Sound evidence recognizes the microbiota as one of the major players in human health and disease, including cancer. Every human being is an holobiont, a shared human and microbial ecosystem, in which microbial composition is individually set by behaviours and environmental factors during the first years of life. Thereafter it is modulated by diet, physical activity, emotions and drugs (in particularly antibiotics and chemotherapeutics). As a consequence, a shift in medicine is needed toward a more comprehensive practice that takes into account every individual's genoma and, in addition, his or her metagenome, known as microbiome: a "microbiota revolution". As regards breast cancer (BC), a clear link between microbiota and oncogenesis is still to be confirmed. Specific microbes display unique features regulating their host niche in a number of body sites, which can result in an increased risk of cancer; in addition, gut microbiota composition plays a role in immune modulation within the intestinal barrier, affecting local and systemic inflammation, recognized drivers of cancer. Moreover, part of the bacterial gene mass inside the gut, constituting the so called “estrobolome”, influences the sexual hormonal balance and subsequentely may impact on the onset, progression and treatment of hormonal dependent cancers. Microbiota is also clearly involved in modulating the response to anticancer treatments, and above all to the emerging immunotherapy. Based on these premises, the microbiome is becoming a potential target, in order to enhance efficacy of antitumoral treatments as well as to lower their toxicity. The complex scenario that links microbiome composition to oncogenesis and response to anticancer treatments defines the frames of a new “oncobiotic” perspective.