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Résumé : ICI has revolutionized the treatment of solid tumors, but durable response has only been observed in a minority of patients, and traditional biomarkers are not sufficient to explain the heterogeneity. Indeed, an increasing body of translational evidence suggests that the gastrointestinal tract microbiome is not merely correlational but a host determinant that can be remodeled to influence immune tone, treatment response, and toxicity. Synthesizing clinical evidence on gut microbiome modulation in clinical primaries and outcomes of immune checkpoint inhibitors in solid tumors, this secondary qualitative analysis has a thematic focus on response, survival, and mechanistic plausibility. Eligible English language studies based on citation chasing were searched through a structured search of PubMed, Europe PMC, Crossref, and Google Scholar. The findings synthesis involved fifteen primary studies, and theoretical framing and discussion were conducted by a separate review of the literature. Three common patterns were found in the thematic analysis. First, responder phenotypes were repeatedly associated with higher microbial diversity and microbial enrichment, including Akkermansia, Ruminococcaceae, Faecalibacterium, and Bifidobacterium. Second, in certain environments, uncontrolled exposure to antibiotics and, in others, uncontrolled exposure to probiotics seemed to undermine the integrity of the ecological response and the effectiveness of checkpoints, even though confounding is widespread. Third, proactive microbiome engineering using fecal microbiota transplantation, high-fiber diets, and live bacterial products demonstrated a proof of concept that gut microbial communities can be therapeutically manipulated to make them more responsive to checkpoint therapy. They had strengths in methodology, as they employed translational designs that linked stool sequencing to clinical endpoints, but were also limited, particularly by small sample sizes, uneven sequencing platforms, tumor heterogeneity, and insufficient controls for diet, antibiotics, and geography. Altogether, evidence shows that the gut microbiome is biologically plausible and clinically implementable as a controller of checkpoints, and current evidence is too heterogeneous to support simple blanket prescriptions. Interventional trials that are adequately powered and precision microbiome stratification are now prioritized.