Core Viewpoint - Fecal Microbiota Transplantation (FMT) shows potential in immunotherapy, but its efficacy in Non-Small Cell Lung Cancer (NSCLC) remains unclear [3][4]. Group 1: Research Findings - A prospective clinical trial combining FMT with immunotherapy was conducted in lung adenocarcinoma, revealing that intra-species genetic heterogeneity among strains plays a decisive role in treatment outcomes [4]. - The study established that the colonization dynamics and functional contributions of individual strains follow a conserved principle that transcends disease-specific contexts, laying the groundwork for precision microbiome therapy [4][11]. - The research team identified 38 priority gut strains with strong colonization potential and significant heterogeneity as candidates for precision treatment [9]. Group 2: Mechanisms and Implications - The success of microbiome therapy is influenced not only by the presence of beneficial microbes but also by strain-specific characteristics, which are crucial for effective colonization and therapeutic potential [7][8]. - The study confirmed that FMT can enhance the efficacy of anti-PD-1 therapy and prolong progression-free survival in a trial involving advanced PD-L1 negative NSCLC [8]. - The findings establish a strain-function-efficacy paradigm, elucidating the mechanistic basis for different clinical outcomes of FMT and providing guidance for the development of next-generation microbiome drugs [11].