Lacticaseibacillus rhamnosus GG enhances gefitinib efficacy and reduces treatment-related toxicity via propionyl-L-carnitine regulation.

Lacticaseibacillus rhamnosus GG enhances gefitinib efficacy and reduces gastrointestinal and hepatic toxicity without changing systemic drug levels in mice.

• Why it matters: Improving gefitinib treatment outcomes for EGFR-mutant non-small cell lung cancer is limited by toxicity; microbiota-based strategies could offer safer, more effective therapies.
• What they did: Researchers tested probiotic strains and identified LGG as the most effective in boosting gefitinib's antitumor effects and reducing injury, using metabolomic analyses, organ-on-a-chip models, and metabolic profiling.
• The result: LGG's benefits are linked to propionyl-L-carnitine, which mimics LGG's effects by modulating mitochondrial metabolism, decreasing NF-κB/IL-6 signaling, and increasing apoptosis, suggesting a microbiota-based approach to improve treatment.