Work

The gut microbiome in colorectal cancer: mechanisms of carcinogenesis and emerging microbiota-targeted therapies

Year: 2026

Type: article

Abstract: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality globally. Beyond established genetic and environmental risk factors, the gut microbiome is now recognized as a pivotal contributor to CRC pathogenesis, progression, and therapeutic response. This review synthesizes current evidence on how dysbiosis and specific pathogenic bacteria—notably Fusobacterium nucleatum (Fn), Enterotoxigenic Bacteroides fragilis (ETBF), and Escherichia coli carrying the polyketide synthase genomic island (pks+ E. coli)—may drive carcinogenesis through chronic inflammation, genotoxic metabolite production, immune evasion, and epigenetic reprogramming. Critically, we explore the microbiome’s dual role in modulating conventional therapies: Fn is linked to chemotherapy resistance and metastasis, while certain commensals may enhance radiotherapy and immunotherapy efficacy. We further evaluate emerging microbiota-targeted strategies, including fecal microbiota tra nsplantation (FMT), probiotics, prebiotics, postbiotics and precision antibiotics, which hold promise for restoring microbial balance and overcoming treatment resistance. By integrating mechanistic insights with clinical evidence, this review provides a foundation for leveraging the microbiome in CRC diagnosis, prognosis, and next-generation therapeutic approaches.

Source: Discover Oncology

DOI: 10.1007/s12672-025-04367-1

Authors: Yue Li, Xingyu Shen, Deqiang Wang, Kang Sun

Institution: Affiliated Hospital of Jiangsu University

Language: English

Topic: Gut microbiota and health

Subfield: Molecular Biology

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,690