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**MBR-01** is a standardized oral mixed probiotic/prebiotic dietary supplement studied as supportive prophylaxis for abemaciclib-associated diarrhea in patients with high-risk, hormone receptor-positive, HER2-negative early breast cancer receiving adjuvant abemaciclib plus letrozole. It is intended to modulate and stabilize the gut microbiota, thereby limiting treatment-associated dysbiosis and gastrointestinal toxicity. In a small single-center prospective case-control study, MBR-01 was associated with reduced diarrhea frequency and severity, preserved microbial diversity, improved quality-of-life measures, and maintenance of abemaciclib dose intensity; the evidence base remains limited to this pilot study. ([medrxiv.org](https://www.medrxiv.org/content/10.64898/2026.02.13.26346277v1))
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