Re-arming checkpoint blockade in MSS colorectal cancer: A precision-microbiome playbook from mechanisms to clinic
Year: 2026
Type: article
Abstract: Immune checkpoint blockade transforms outcomes for the 15% of colorectal cancers (CRCs) with mismatch-repair deficiency; yet most tumours remain refractory.Beneficial gut microbes can change this.Akkermansia muciniphila, Bacteroides fragilis, and short-chain fatty acid producers prime dendritic cells to produce interleukin (IL)-12, polarise Th1 cells, and reinvigorate CD8 + T-cells.Antibiotics, Western-style diets, and Fusobacterium nucleatum foster myeloid suppression and β-catenin-or IL-17-mediated signalling, which blunt checkpoint activity.Multi-omics analyses link biosynthetic genes for inosine, riboflavin, and folate to durable clinical benefit.Faecal microbiota transplantation from responders has produced objective regressions in otherwise refractory microsatellitestable disease.This narrative review maps CRC-microbiota-immune crosstalk, evaluates biomarkers and interventions, and proposes a CRC-specific, threetiered clinical algorithm.We outline standards for trial design and manufacturing processes to facilitate the translation of microbiota-guided therapy into routine practice.
Source: Turkish Journal of Surgery
Institutions: Zhongda Hospital Southeast University, Southeast University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7160655866
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