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This comprehensive review delineates the multifaceted roles of bacteria, viruses, and fungi in modulating the tumor microenvironment and systemic immunity across diverse cancer types. We synthesize current evidence on how microbial dysbiosis promotes carcinogenesis via chronic inflammation, metabolic reprogramming, genotoxic stress, immune evasion, and epigenetic remodeling. This review emphasizes organ\u2010specific microbiome signatures and highlights their potential as non\u2010invasive biomarkers for early detection, treatment stratification, and prognosis. Furthermore, we explore the impact of intratumoral microbiota on cancer therapies, uncovering how microbial metabolites and host\u2013microbe interactions shape therapeutic efficacy and resistance. Finally, advances in microbiome\u2010targeted strategies, such as probiotics, fecal microbiota transplantation, and engineered microbes offer new avenues for adjunctive cancer therapy. This review provides a roadmap for future investigation and underscores the transformative promise of microbiome modulation in cancer prevention and treatment.<\/jats:p>","DOI":"10.1002\/imt2.70070","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T05:44:07Z","timestamp":1756619047000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["The microbiome in cancer"],"prefix":"10.1002","volume":"4","author":[{"given":"Anqi","family":"Lin","sequence":"first","affiliation":[{"name":"Donghai County People's Hospital (Affiliated Kangda College of Nanjing Medical University) Lianyungang China"},{"name":"Department of Oncology Zhujiang Hospital, Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minying","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Oncology Zhujiang Hospital, Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Urology Changhai hospital, Naval Medical University (Second Military Medical University) Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihaoyun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oncology Zhujiang Hospital, Southern Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hank Z. 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