药物是我们对抗许多疾病的第一道防线，有时也是最后一道防线，然而，尽管经过了数十年的研究，我们仍然不完全理解为什么某种药物对一个患者有效，而在下一个患者中却失效。人类肠道微生物组是缺失的拼图之一，因为它能够平行和扩展宿主的药物代谢途径，以及更复杂的宿主-微生物组相互作用。在此，我们重点关注肠道微生物组与治疗心脏病和癌症的药物之间的既定联系，以及有关神经系统疾病的新数据。我们重点介绍可用的跨学科方法，以及如何利用它们来解决主要的知识空白，包括微生物药物代谢对治疗结果的影响。该领域的持续进展有望对人类及其相关微生物群落产生基本的生物学见解，并提供利用微生物组改善医学实践的策略。

Drugs represent our first, and sometimes last, line of defense for many diseases, yet despite decades of research we still do not fully understand why a given drug works in one patient and fails in the next. The human gut microbiome is one of the missing puzzle pieces, due to its ability to parallel and extend host pathways for drug metabolism, along with more complex host-microbiome interactions. Herein, we focus on the well-established links between the gut microbiome and drugs for heart disease and cancer, plus emerging data on neurological disease. We highlight the interdisciplinary methods that are available and how they can be used to address major remaining knowledge gaps, including the consequences of microbial drug metabolism for treatment outcomes. Continued progress in this area promises fundamental biological insights into humans and their associated microbial communities and strategies for leveraging the microbiome to improve the practice of medicine.