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Résumé : The interplay between psychological distress, gut microbiota composition, and immune function represents an emerging frontier in psycho oncology. Tumor associated depression exerts profound biological effects through activation of the hypothalamic pituitary adrenal axis and upregulation of proinflammatory cytokines, which can impair T cell function and reduce the efficacy of immune checkpoint inhibitors. This review specifically distinguishes between major depressive disorder (diagnosed via structured clinical interviews) and subsyndromal depressive symptoms (measured by self-report scales), as their biological correlates may differ. Concurrently, the gut microbiota gut brain axis acts as a critical mediator linking mood, immunity, and cancer progression. Microbial metabolites such as short chain fatty acids and tryptophan derivatives influence neurotransmission and cytokine production, thereby regulating both emotional states and immune competence. Dysbiosis disrupts these mechanisms, leading to systemic inflammation and therapeutic resistance. This narrative review synthesizes current evidence on how tumor associated depression and gut microbial alterations jointly modulate immune checkpoint activity. Unlike prior reviews that focus solely on inflammation, the present work proposes an innovative psycho-microbiological framework that integrates emotional resilience, microbial ecology, and immune regulation within a shared therapeutic continuum. It further explores microbial based sensitization strategies such as probiotics, prebiotics, synbiotics, and fecal microbiota transplantation that may restore microbial balance, reduce inflammation, and enhance immunotherapy response. By integrating psychoneuroimmunology and microbiome science, the review proposes an innovative psycho microbiological framework that unites emotional resilience, microbial ecology, and immune regulation within a shared therapeutic continuum. Understanding this interconnection offers a path toward personalized cancer care in which psychological and microbial interventions complement conventional immunotherapy to achieve durable recovery and improved quality of life.