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Lung cancer, one of the leading causes of cancer-related deaths worldwide, severely influences patients' quality of life and prognosis due to its complication of brain metastasis (primarily involving the brain parenchyma). While traditional treatments such as surgery, radiotherapy, and chemotherapy have demonstrated efficacy in clinical practice, their application remains limited due to toxicity and patient tolerance issues. Emerging targeted therapies and immunotherapies, which exhibit significant efficacy with fewer side effects, still face challenges including partial drug resistance and genetic mutations. In recent years, research on the association between gut microbiota and lung cancer brain metastasis has gained prominence. Its mechanism of action may influence the progression of brain metastasis through multidimensional interactions via the brain-gut axis, involving neuroendocrine and immune pathways. This review examines specific mechanisms by which gut microbiota modulate lung cancer brain metastasis through immune regulation, endocrine-metabolic regulation, and neurotransmitter control via the brain-gut axis, as well as therapeutic and traditional medicine research on regulating gut microbiota in lung cancer brain metastasis. It aims to provide theoretical support and identify potential clinical therapeutic targets for the prevention and treatment of lung cancer brain metastasis.
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