Towards modulating the gut microbiota to enhance the efficacy of immune-checkpoint inhibitors
Abstract
The gut microbiota modulates immune processes both locally and systemically. This includes whether and how the immune system reacts to emerging tumours, whether antitumour immune responses are reactivated during treatment with immune-checkpoint inhibitors (ICIs), and whether unintended destructive immune pathologies accompany such treatment. Advances over the past decade have established that the gut microbiota is a promising target and that modulation of the microbiota might overcome resistance to ICIs and/or improve the safety of treatment. However, the specific mechanisms through which the microbiota modulates antitumour immunity remain unclear. Understanding the biology underpinning microbial associations with clinical outcomes in patients receiving ICIs, as well as the landscape of a 'healthy' microbiota would provide a critical foundation to facilitate opportunities to effectively manipulate the microbiota and thus improve patient outcomes. In this Review, we explore the role of diet and the gut microbiota in shaping immune responses during treatment with ICIs and highlight the key challenges in attempting to leverage the gut microbiome as a practical tool for the clinical management of patients with cancer.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A key strength of FMT is the ability to transfer both favorable microbes and their intricate supporting ecosystem.
“A key strength of FMT is the ability to transfer both the favorable microbes, as well as their intricate supporting ecosystem.726”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [726]
FMT is considered a broad and largely untargeted gut microbiota modulation strategy, pitting donor microbial ecosystems against those of the recipient.
“It is considered a broad and largely untargeted gut microbiota modulation strategy, pitting donor microbial ecosystems against those of the recipient.726”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [726]
FMT is limited by its variable degree of engraftment, limited scalability, and a lack of standardized protocols.
“In addition, FMT is limited by its variable degree of engraftment, limited scalability, and a lack of standardized protocols.725,726”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [726]
Cites
Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma
Larkin, J., Chiarion-Sileni, V., Gonzalez, R., Grob, J. J., Cowey, C. L., Lao, C. D., Schadendorf, D., Dummer, R., Smylie, M., Rutkowski, P., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504030 · Cited by 8,157 · see citing works
Self-citationMutational landscape determines sensitivity to PD-1 blockade in non–small cell lung cancer
Rizvi, N. A., Hellmann, M. D., Snyder, A., Kvistborg, P., Makarov, V., Havel, J. J., Lee, W., Yuan, J., Wong, P., Ho, T. S., et al. (2015) · Science · doi:10.1126/science.aaa1348 · Cited by 7,802 · see citing works
PD-1 blockade induces responses by inhibiting adaptive immune resistance
Tumeh, P. C., Harview, C. L., Yearley, J. H., Shintaku, I. P., Taylor, E. J. M., Robert, L., Chmielowski, B., Spasic, M., Henry, G., Ciobanu, V., et al. (2014) · Nature · doi:10.1038/nature13954 · Cited by 6,609 · see citing works
Gut microbiome influences efficacy of PD-1-based immunotherapy against epithelial tumors
Routy, B., Le Chatelier, E., Derosa, L., Duong, C. P. M., Alou, M. T., Daillère, R., Fluckiger, A., Messaoudene, M., Rauber, C., Roberti, M. P., et al. (2018) · Science · doi:10.1126/science.aan3706 · Cited by 5,671 · see citing works
Commensal microbe-derived butyrate induces the differentiation of colonic regulatory T cells
Furusawa, Y., Obata, Y., Fukuda, S., Endo, T. A., Nakato, G., Takahashi, D., Nakanishi, Y., Uetake, C., Kato, K., Kato, T., et al. (2013) · Nature · doi:10.1038/nature12721 · Cited by 5,549 · see citing works
Smith, P. M., Howitt, M. R., Panikov, N., Michaud, M., Gallini, C. A., Bohlooly-Y, M., Glickman, J. N., & Garrett, W. S. (2013) · Science · doi:10.1126/science.1241165 · Cited by 5,413 · see citing works
Overall Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma
Wolchok, J. D., Chiarion-Sileni, V., Gonzalez, R., Rutkowski, P., Grob, J.-J., Cowey, C. L., Lao, C. D., Wagstaff, J., Schadendorf, D., Ferrucci, P. F., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1709684 · Cited by 5,357 · see citing works
Self-citationImmune-Related Adverse Events Associated with Immune Checkpoint Blockade
Postow, M. A., Sidlow, R., & Hellmann, M. D. (2018) · New England Journal of Medicine · doi:10.1056/nejmra1703481 · Cited by 4,849 · see citing works
Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation
Arpaia, N., Campbell, C., Fan, X., Dikiy, S., van der Veeken, J., deRoos, P., Liu, H., Cross, J. R., Pfeffer, K., Coffer, P. J., et al. (2013) · Nature · doi:10.1038/nature12726 · Cited by 4,838 · see citing works
Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients
Gopalakrishnan, V., Spencer, C. N., Nezi, L., Reuben, A., Andrews, M. C., Karpinets, T. V., Prieto, P. A., Vicente, D., Hoffman, K., Wei, S. C., et al. (2018) · Science · doi:10.1126/science.aan4236 · Cited by 4,812 · see citing works
Commensal <i>Bifidobacterium</i> promotes antitumor immunity and facilitates anti–PD-L1 efficacy
Sivan, A., Corrales, L., Hubert, N., Williams, J. B., Aquino-Michaels, K., Earley, Z. M., Benyamin, F. W., Man Lei, Y., Jabri, B., Alegre, M.-L., et al. (2015) · Science · doi:10.1126/science.aac4255 · Cited by 3,888 · see citing works
Anticancer immunotherapy by CTLA-4 blockade relies on the gut microbiota
Vétizou, M., Pitt, J. M., Daillère, R., Lepage, P., Waldschmitt, N., Flament, C., Rusakiewicz, S., Routy, B., Roberti, M. P., Duong, C. P. M., et al. (2015) · Science · doi:10.1126/science.aad1329 · Cited by 3,488 · see citing works
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019) · Microorganisms · doi:10.3390/microorganisms7010014 · Cited by 3,462 · see citing works
Zehir, A., Benayed, R., Shah, R. H., Syed, A., Middha, S., Kim, H. R., Srinivasan, P., Gao, J., Chakravarty, D., Devlin, S. M., et al. (2017) · Nature Medicine · doi:10.1038/nm.4333 · Cited by 3,380 · see citing works
Human Genetics Shape the Gut Microbiome
Goodrich, J. K., Waters, J. L., Poole, A. C., Sutter, J. L., Koren, O., Blekhman, R., Beaumont, M., Van Treuren, W., Knight, R., Bell, J. T., et al. (2014) · Cell · doi:10.1016/j.cell.2014.09.053 · Cited by 3,164 · see citing works
The commensal microbiome is associated with anti-PD-1 efficacy in metastatic melanoma patients
Matson, V., Fessler, J., Bao, R., Chongsuwat, T., Zha, Y., Alegre, M.-L., Luke, J. J., & Gajewski, T. F. (2018) · Science · doi:10.1126/science.aao3290 · Cited by 3,107 · see citing works
The Effect of Diet on the Human Gut Microbiome: A Metagenomic Analysis in Humanized Gnotobiotic Mice
Turnbaugh, P. J., Ridaura, V. K., Faith, J. J., Rey, F. E., Knight, R., & Gordon, J. I. (2009) · Science Translational Medicine · doi:10.1126/scitranslmed.3000322 · Cited by 3,058 · see citing works
Gut microbiota functions: metabolism of nutrients and other food components
Rowland, I., Gibson, G., Heinken, A., Scott, K., Swann, J., Thiele, I., & Tuohy, K. (2018) · European Journal of Nutrition · doi:10.1007/s00394-017-1445-8 · Cited by 2,878 · see citing works
Environment dominates over host genetics in shaping human gut microbiota
Rothschild, D., Weissbrod, O., Barkan, E., Kurilshikov, A., Korem, T., Zeevi, D., Costea, P. I., Godneva, A., Kalka, I. N., Bar, N., et al. (2018) · Nature · doi:10.1038/nature25973 · Cited by 2,859 · see citing works
Desai, M. S., Seekatz, A. M., Koropatkin, N. M., Kamada, N., Hickey, C. A., Wolter, M., Pudlo, N. A., Kitamoto, S., Terrapon, N., Muller, A., et al. (2016) · Cell · doi:10.1016/j.cell.2016.10.043 · Cited by 2,805 · see citing works
Influence of diet on the gut microbiome and implications for human health
Singh, R. K., Chang, H.-W., Yan, D., Lee, K. M., Ucmak, D., Wong, K., Abrouk, M., Farahnik, B., Nakamura, M., Zhu, T. H., et al. (2017) · Journal of Translational Medicine · doi:10.1186/s12967-017-1175-y · Cited by 2,599 · see citing works
The gut microbiota and host health: a new clinical frontier
Marchesi, J. R., Adams, D. H., Fava, F., Hermes, G. D. A., Hirschfield, G. M., Hold, G., Quraishi, M. N., Kinross, J., Smidt, H., Tuohy, K. M., et al. (2016) · Gut · doi:10.1136/gutjnl-2015-309990 · Cited by 2,302 · see citing works
Fecal microbiota transplant overcomes resistance to anti–PD-1 therapy in melanoma patients
Davar, D., Dzutsev, A. K., McCulloch, J. A., Rodrigues, R. R., Chauvin, J.-M., Morrison, R. M., Deblasio, R. N., Menna, C., Ding, Q., Pagliano, O., et al. (2021) · Science · doi:10.1126/science.abf3363 · Cited by 1,781 · see citing works
Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients
Baruch, E. N., Youngster, I., Ben-Betzalel, G., Ortenberg, R., Lahat, A., Katz, L., Adler, K., Dick-Necula, D., Raskin, S., Bloch, N., et al. (2021) · Science · doi:10.1126/science.abb5920 · Cited by 1,757 · see citing works
Zmora, N., Zilberman-Schapira, G., Suez, J., Mor, U., Dori-Bachash, M., Bashiardes, S., Kotler, E., Zur, M., Regev-Lehavi, D., Brik, R. B.-Z., et al. (2018) · Cell · doi:10.1016/j.cell.2018.08.041 · Cited by 1,695 · see citing works
Carbohydrate quality and human health: a series of systematic reviews and meta-analyses
Reynolds, A., Mann, J., Cummings, J., Winter, N., Mete, E., & Te Morenga, L. (2019) · The Lancet · doi:10.1016/s0140-6736(18)31809-9 · Cited by 1,630 · see citing works
Microbiome-derived inosine modulates response to checkpoint inhibitor immunotherapy
Mager, L. F., Burkhard, R., Pett, N., Cooke, N. C. A., Brown, K., Ramay, H., Paik, S., Stagg, J., Groves, R. A., Gallo, M., et al. (2020) · Science · doi:10.1126/science.abc3421 · Cited by 1,407 · see citing works
Oliphant, K., & Allen-Vercoe, E. (2019) · Microbiome · doi:10.1186/s40168-019-0704-8 · Cited by 1,327 · see citing works
Cancer despite immunosurveillance: immunoselection and immunosubversion
Zitvogel, L., Tesniere, A., & Kroemer, G. (2006) · Nature reviews. Immunology · doi:10.1038/nri1936 · Cited by 1,324 · see citing works
Chaput, N., Lepage, P., Coutzac, C., Soularue, E., Le Roux, K., Monot, C., Boselli, L., Routier, E., Cassard, L., Collins, M., et al. (2017) · Annals of Oncology · doi:10.1093/annonc/mdx108 · Cited by 1,310 · see citing works
Glycan foraging in vivo by an intestine-adapted bacterial symbiont
Sonnenburg, J. L., Xu, J., Leip, D. D., Chen, C.-H., Westover, B. P., Weatherford, J., Buhler, J. D., & Gordon, J. I. (2005) · Science · doi:10.1126/science.1109051 · Cited by 1,184 · see citing works
Enterotypes in the landscape of gut microbial community composition
Costea, P. I., Hildebrand, F., Arumugam, M., Bäckhed, F., Blaser, M. J., Bushman, F. D., de Vos, W. M., Ehrlich, S. D., Fraser, C. M., Hattori, M., et al. (2017) · Nature Microbiology · doi:10.1038/s41564-017-0072-8 · Cited by 1,138 · see citing works
Dubin, K., Callahan, M. K., Ren, B., Khanin, R., Viale, A., Ling, L., No, D., Gobourne, A., Littmann, E., Huttenhower, C., et al. (2016) · Nature Communications · doi:10.1038/ncomms10391 · Cited by 987 · see citing works
Next-generation probiotics: the spectrum from probiotics to live biotherapeutics
O’Toole, P. W., Marchesi, J. R., & Hill, C. (2017) · Nature Microbiology · doi:10.1038/nmicrobiol.2017.57 · Cited by 971 · see citing works
Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response
Spencer, C. N., McQuade, J. L., Gopalakrishnan, V., McCulloch, J. A., Vetizou, M., Cogdill, A. P., Khan, M. A. W., Zhang, X., White, M. G., Peterson, C. B., et al. (2021) · Science · doi:10.1126/science.aaz7015 · Cited by 966 · see citing works
Daillère, R., Vétizou, M., Waldschmitt, N., Yamazaki, T., Isnard, C., Poirier-Colame, V., Duong, C. P. M., Flament, C., Lepage, P., Roberti, M. P., et al. (2016) · Immunity · doi:10.1016/j.immuni.2016.09.009 · Cited by 897 · see citing works
American Gut: an Open Platform for Citizen-Science Microbiome Research
McDonalda, D., Hyde, E., Debelius, J. W., Morton, J. T., Gonzalez, A., Ackermann, G., Aksenov, A. A., Behsaz, B., Brennan, C., Chen, Y., et al. (2018) · doi:10.1101/277970 · Cited by 878 · see citing works
Blank, C. U., Haanen, J. B., Ribas, A., & Schumacher, T. N. (2016) · Science · doi:10.1126/science.aaf2834 · Cited by 748 · see citing works
Fecal microbiota transplantation for refractory immune checkpoint inhibitor-associated colitis
Wang, Y., Wiesnoski, D. H., Helmink, B. A., Gopalakrishnan, V., Choi, K., DuPont, H. L., Jiang, Z.-D., Abu-Sbeih, H., Sanchez, C. A., Chang, C.-C., et al. (2018) · Nature Medicine · doi:10.1038/s41591-018-0238-9 · Cited by 740 · see citing works
Frankel, A. E., Coughlin, L. A., Kim, J., Froehlich, T. W., Xie, Y., Frenkel, E. P., & Koh, A. Y. (2017) · Neoplasia · doi:10.1016/j.neo.2017.08.004 · Cited by 709 · see citing works
Bachem, A., Makhlouf, C., Binger, K. J., de Souza, D. P., Tull, D., Hochheiser, K., Whitney, P. G., Fernandez-Ruiz, D., Dähling, S., Kastenmüller, W., et al. (2019) · Immunity · doi:10.1016/j.immuni.2019.06.002 · Cited by 702 · see citing works
Jordan, E. J., Kim, H. R., Arcila, M. E., Barron, D., Chakravarty, D., Gao, J., Chang, M. T., Ni, A., Kundra, R., Jonsson, P., et al. (2017) · Cancer Discovery · doi:10.1158/2159-8290.cd-16-1337 · Cited by 643 · see citing works
Pinato, D. J., Howlett, S., Ottaviani, D., Urus, H., Patel, A., Mineo, T., Brock, C., Power, D., Hatcher, O., Falconer, A., et al. (2019) · JAMA Oncology · doi:10.1001/jamaoncol.2019.2785 · Cited by 626 · see citing works
Dizman, N., Meza, L., Bergerot, P., Alcantara, M., Dorff, T., Lyou, Y., Frankel, P., Cui, Y., Mira, V., Llamas, M., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01694-6 · Cited by 515 · see citing works
Microbiota-derived 3-IAA influences chemotherapy efficacy in pancreatic cancer
Tintelnot, J., Xu, Y., Lesker, T. R., Schönlein, M., Konczalla, L., Giannou, A. D., Pelczar, P., Kylies, D., Puelles, V. G., Bielecka, A. A., et al. (2023) · Nature · doi:10.1038/s41586-023-05728-y · Cited by 478 · see citing works
McCulloch, J. A., Davar, D., Rodrigues, R. R., Badger, J. H., Fang, J. R., Cole, A. M., Balaji, A. K., Vetizou, M., Prescott, S. M., Fernandes, M. R., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01698-2 · Cited by 472 · see citing works
Lee, K. A., Thomas, A. M., Bolte, L. A., Björk, J. R., de Ruijter, L. K., Armanini, F., Asnicar, F., Blanco-Miguez, A., Board, R., Calbet-Llopart, N., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01695-5 · Cited by 464 · see citing works
Gut microbiota signatures are associated with toxicity to combined CTLA-4 and PD-1 blockade
Andrews, M. C., Duong, C. P. M., Gopalakrishnan, V., Iebba, V., Chen, W.-S., Derosa, L., Khan, M. A. W., Cogdill, A. P., White, M. G., Wong, M. C., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01406-6 · Cited by 437 · see citing works
Horai, R., Zárate-Bladés, C. R., Dillenburg-Pilla, P., Chen, J., Kielczewski, J. L., Silver, P. B., Jittayasothorn, Y., Chan, C.-C., Yamane, H., Honda, K., et al. (2015) · Immunity · doi:10.1016/j.immuni.2015.07.014 · Cited by 402 · see citing works
Derosa, L., Routy, B., Fidelle, M., Iebba, V., Alla, L., Pasolli, E., Segata, N., Desnoyer, A., Pietrantonio, F., Ferrere, G., et al. (2020) · European Urology · doi:10.1016/j.eururo.2020.04.044 · Cited by 398 · see citing works
Compartmentalized and systemic control of tissue immunity by commensals
Belkaid, Y., & Naik, S. (2013) · Nature Immunology · doi:10.1038/ni.2604 · Cited by 382 · see citing works
<i>Enterococcus</i> peptidoglycan remodeling promotes checkpoint inhibitor cancer immunotherapy
Griffin, M. E., Espinosa, J., Becker, J. L., Luo, J.-D., Carroll, T. S., Jha, J. K., Fanger, G. R., & Hang, H. C. (2021) · Science · doi:10.1126/science.abc9113 · Cited by 366 · see citing works
Patnode, M. L., Beller, Z. W., Han, N. D., Cheng, J., Peters, S. L., Terrapon, N., Henrissat, B., Le Gall, S., Saulnier, L., Hayashi, D. K., et al. (2019) · Cell · doi:10.1016/j.cell.2019.08.011 · Cited by 329 · see citing works
Han, K., Nam, J., Xu, J., Sun, X., Huang, X., Animasahun, O., Achreja, A., Jeon, J. H., Pursley, B., Kamada, N., et al. (2021) · Nature Biomedical Engineering · doi:10.1038/s41551-021-00749-2 · Cited by 287 · see citing works
Moving from probiotics to precision probiotics
Veiga, P., Suez, J., Derrien, M., & Elinav, E. (2020) · Nature Microbiology · doi:10.1038/s41564-020-0721-1 · Cited by 235 · see citing works
Fucà, G., Galli, G., Poggi, M., Lo Russo, G., Proto, C., Imbimbo, M., Ferrara, R., Zilembo, N., Ganzinelli, M., Sica, A., et al. (2019) · ESMO Open · doi:10.1136/esmoopen-2018-000457 · Cited by 209 · see citing works
Botticelli, A., Vernocchi, P., Marini, F., Quagliariello, A., Cerbelli, B., Reddel, S., Del Chierico, F., Di Pietro, F., Giusti, R., Tomassini, A., et al. (2020) · Journal of Translational Medicine · doi:10.1186/s12967-020-02231-0 · Cited by 209 · see citing works
Gut microbiome modulates efficacy of immune checkpoint inhibitors
Yi, M., Yu, S., Qin, S., Liu, Q., Xu, H., Zhao, W., Chu, Q., & Wu, K. (2018) · Journal of Hematology & Oncology · doi:10.1186/s13045-018-0592-6 · Cited by 179 · see citing works
Zhu, C., Sawrey-Kubicek, L., Beals, E., Rhodes, C. H., Houts, H. E., Sacchi, R., & Zivkovic, A. M. (2020) · Nutrition Research · doi:10.1016/j.nutres.2020.03.005 · Cited by 153 · see citing works
Spreafico, A., Heirali, A. A., Araujo, D. V., Tan, T. J., Oliva, M., Schneeberger, P. H. H., Chen, B., Wong, M. K., Stayner, L.-A., Hansen, A. R., et al. (2023) · Annals of Oncology · doi:10.1016/j.annonc.2023.02.011 · Cited by 96 · see citing works
Can we harness the microbiota to enhance the efficacy of cancer immunotherapy?
Finlay, B. B., Goldszmid, R., Honda, K., Trinchieri, G., Wargo, J., & Zitvogel, L. (2020) · Nature Reviews Immunology · doi:10.1038/s41577-020-0374-6 · Cited by 81 · see citing works
How microbiota improve immunotherapy
Ansaldo, E., & Belkaid, Y. (2021) · Science · doi:10.1126/science.abl3656 · Cited by 54 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases
Loh, J. S., Mak, W. Q., Tan, L. K. S., Ng, C. X., Chan, H. H., Yeow, S. H., Foo, J. B., Ong, Y. S., How, C. W., & Khaw, K. Y. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01743-1 · Cited by 1,193 · see citing works
Gut microbial metabolites in cancer therapy
Song, P., Peng, Z., & Guo, X. (2025) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2024.06.016 · Cited by 38 · see citing works
- Authors
- Simpson, R. C., Shanahan, E. R., Scolyer, R. A., & Long, G. V.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Long, Georgina V.
- Venue
- Nature Reviews Clinical Oncology
- Published
- 2023-07-24
- Volume
- 20
- Issue
- 10
- Pages
- 697-715
- ISSN
- 1759-4774 (ISSN-L)
- 1759-4782
- OpenAlex
- W4385230873
- Semantic Scholar
- dc7ac6f594cc862dec2d3f7a1035537892c1711a
- Cited by
- 153
- References
- 62
- Citations by year
- 2026: 54 · 2025: 58 · 2024: 36 · 2023: 5
- FWCI
- 4.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Reviews Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Keywords
- gut microbiota, immune checkpoint inhibitors, antitumor immunity, microbiota modulation, cancer immunotherapy, immune checkpoint inhibitor resistance, immune-related adverse events, immune homeostasis, cancer immunotherapy safety
- MeSH terms
- Gastrointestinal Microbiome, Immune Checkpoint Inhibitors, Humans, Neoplasms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
