The microbiome, which refers to the microbiota within a host and their collective genomes, has recently been demonstrated to play a critical role in cancer progression, metastasis, and therapeutic response. The microbiome is known to affect host immunity, but its influence on human papilloma virus (HPV) gynecologic malignancies remains limited and poorly understood. To date, studies have largely focused on the cervicovaginal microbiome; however, there is growing evidence that the gut microbiome may interact and substantially affect therapeutic response in gynecologic cancers. Importantly, new developments in microbiome sequencing and advanced bioinformatics technologies have enabled rapid advances in our understanding of the gut and local tumor microbiota. In this review, we examine the evidence supporting the role of the microbiome in HPV-associated cervical intraepithelial neoplasia (CIN) and cervical cancer, explore characteristics that influence and shape the host microbiota that impact HPV-driven carcinogenesis, and highlight potential approaches and considerations for future and ongoing research of the microbiome's effect on HPV-associated cancer.

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Competing Interests

Source of Support: This research was supported in part by the National Institutes of Health (NIH) through MD Anderson's Cancer Center Support Grant P30 CA016672 and the NIH T32 grant 5T32 CA101642-14 (Travis T. Sims). This research was partially funded by the MD Anderson HPV-Related Cancers Moonshot (Ann Klopp). Editorial support was provided by Bryan Tutt in Scientific Publications Services, Research Medical Library.

Conflicts of Interest: None.