{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:07:58Z","timestamp":1786122478157,"version":"build-2736575974"},"reference-count":57,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"},{"id":[{"id":"https:\/\/ror.org\/031d5vw30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Microsatellite-stable colorectal cancer (MSS CRC) accounts for the vast majority of CRC cases and remains largely resistant to immune checkpoint inhibitors. Emerging evidence suggests that the gut microbiome is an important regulator of antitumor immunity and may contribute to immunotherapy resistance through multiple mechanisms involving the tumor microenvironment. This review aims to summarize current knowledge of the microbiome\u2013immunity\u2013therapy axis in MSS CRC and to explore microbiome-based strategies to enhance immunotherapy responsiveness. Methods: A narrative review of the recent literature was conducted, focusing on studies published within the last five years that investigated gut microbiota composition, microbial metabolites, tumor immune regulation, immunotherapy response, and microbiome-targeted therapeutic interventions in CRC. Evidence from mechanistic studies, translational research, clinical investigations, and multi-omics analyses was integrated. Results: Current evidence indicates that gut dysbiosis contributes to immune resistance in MSS CRC through immune exclusion, myeloid-driven immunosuppression, T-cell dysfunction, chronic inflammation, and altered microbial metabolite signaling. Specific microorganisms, including Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, pks-positive Escherichia coli, and other CRC-associated pathobionts, have been implicated in tumor progression and modulation of antitumor immunity. Microbial metabolites such as short-chain fatty acids, tryptophan-derived compounds, bile acids, succinate, and inosine represent key functional mediators linking microbial communities to host immune responses. Emerging microbiome-targeted interventions, including fecal microbiota transplantation, next-generation probiotics, postbiotics, selective microbial depletion, and engineered bacterial therapeutics, have shown promising results in preclinical models and early translational or clinical studies, although robust clinical evidence remains limited. In parallel, advances in metagenomics, metabolomics, spatial transcriptomics, and artificial intelligence are facilitating the development of precision immuno-microbiome oncology approaches. Conclusions: The gut microbiome functions as a critical regulator of immune resistance in MSS CRC through coordinated effects on microbial composition, metabolite production, and tumor immune remodeling. Microbiome-targeted interventions, combined with multi-omics-based patient stratification, may provide new opportunities to overcome immunotherapy resistance and expand the clinical benefits of immune checkpoint blockade in this traditionally refractory disease.<\/jats:p>","DOI":"10.3390\/cancers18162538","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:12:01Z","timestamp":1786097521000},"page":"2538","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gut Microbiome-Driven Strategies to Overcome Immunotherapy Resistance in Microsatellite-Stable Colorectal Cancer"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4817-1365","authenticated-orcid":false,"given":"Lidia","family":"Boldeanu","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Elena","family":"Ghenea","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Elena Ciobanu","family":"Plasiciuc","sequence":"additional","affiliation":[{"name":"Department of Health and Motricity, Faculty of Medical and Behavioral Sciences, \u201cConstantin Br\u00e2ncu\u0219i\u201d University of T\u00e2rgu-Jiu, 210185 T\u00e2rgu-Jiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2481-6138","authenticated-orcid":false,"given":"Mihail Virgil","family":"Boldeanu","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodica","family":"P\u0103dureanu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3146-8769","authenticated-orcid":false,"given":"Mohamed-Zakaria","family":"Assani","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7398-5689","authenticated-orcid":false,"given":"Vlad","family":"P\u0103dureanu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela","family":"Silo\u0219i","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius Bogdan","family":"Novac","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ancu\u021ba-Ramona Boicea","family":"Camen","sequence":"additional","affiliation":[{"name":"Department of Occupational Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"(2026, May 14). Available online: https:\/\/gco.iarc.who.int\/today\/fact-sheets-cancer\/about?utm."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S1470-2045(22)00197-8","article-title":"Pembrolizumab versus chemotherapy for microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer (KEYNOTE-177): Final analysis of a randomised, open-label, phase 3 study","volume":"23","author":"Diaz","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1200\/JCO.21.01015","article-title":"First-Line Nivolumab Plus Low-Dose Ipilimumab for Microsatellite Instability-High\/Mismatch Repair-Deficient Metastatic Colorectal Cancer: The Phase II CheckMate 142 Study","volume":"40","author":"Lenz","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.annonc.2022.06.008","article-title":"Nivolumab plus low-dose ipilimumab in previously treated patients with microsatellite instability-high\/mismatch repair-deficient metastatic colorectal cancer: 4-year follow-up from CheckMate 142","volume":"33","author":"Lonardi","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Wang, Q., Yu, M., and Zhang, S. (2025). The characteristics of the tumor immune microenvironment in colorectal cancer with different MSI status and current therapeutic strategies. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1440830"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kang, W., Zhang, Z., Li, W., Zhang, Q., Li, N., Jiang, Y., Zhang, J., and He, Y. (2026). Breaching the immune-cold barrier in pMMR\/MSS metastatic colorectal cancer: Emerging strategies beyond standard care. Front. Immunol., 17.","DOI":"10.3389\/fimmu.2026.1773002"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1038\/s41568-025-00872-1","article-title":"The immune microenvironment of colorectal cancer","volume":"25","author":"Kennel","year":"2025","journal-title":"Nat. Rev. Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Andac-Aktas, A.B., and Calibasi-Kocal, G. (2025). Immunological landscape of colorectal cancer: Tumor microenvironment, cellular players and immunotherapeutic opportunities. Front. Mol. Biosci., 12.","DOI":"10.3389\/fmolb.2025.1687556"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ajab, S.M., Zoughbor, S.H., Labania, L.A., \u00d6stlundh, L.M., Orsud, H.S., Olanda, M.A., Alkaabi, O., Alkuwaiti, S.H., Alnuaimi, S.M., and Al Rasbi, Z. (2024). Microbiota composition effect on immunotherapy outcomes in colorectal cancer patients: A systematic review. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0307639"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e156","DOI":"10.1002\/imt2.156","article-title":"Gut microbiota reshapes cancer immunotherapy efficacy: Mechanisms and therapeutic strategies","volume":"3","author":"Xie","year":"2024","journal-title":"iMeta"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/s41522-025-00786-8","article-title":"Gut microbiota shapes cancer immunotherapy responses","volume":"11","author":"Lei","year":"2025","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Incognito, D., Ciappina, G., Gelsomino, C., Picone, A., Consolo, P., Scano, A., Franchina, T., Maurea, N., Quagliariello, V., and Berretta, S. (2025). Fusobacterium Nucleatum in Colorectal Cancer: Relationship Among Immune Modulation, Potential Biomarkers and Therapeutic Implications. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26199710"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pereira, F., Ferreira, A., Reis, C.A., Sousa, M.J., Oliveira, M.J., and Preto, A. (2022). KRAS as a Modulator of the Inflammatory Tumor Microenvironment: Therapeutic Implications. Cells, 11.","DOI":"10.3390\/cells11030398"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Sun, Q., Wu, J., Zhu, G., Li, T., Zhu, X., Ni, B., Xu, B., Ma, X., and Li, J. (2023). Lactate-related metabolic reprogramming and immune regulation in colorectal cancer. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1089918"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1038\/s41420-024-01865-z","article-title":"The effects of metabolism on the immune microenvironment in colorectal cancer","volume":"10","author":"Chen","year":"2024","journal-title":"Cell Death Discov."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Nicolini, A., and Ferrari, P. (2024). Involvement of tumor immune microenvironment metabolic reprogramming in colorectal cancer progression, immune escape, and response to immunotherapy. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1353787"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1038\/s41579-023-00973-4","article-title":"The microbial landscape of colorectal cancer","volume":"22","author":"White","year":"2024","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Galasso, L., Termite, F., Mignini, I., Esposto, G., Borriello, R., Vitale, F., Nicoletti, A., Paratore, M., Ainora, M.E., and Gasbarrini, A. (2025). Unraveling the Role of Fusobacterium nucleatum in Colorectal Cancer: Molecular Mechanisms and Pathogenic Insights. Cancers, 17.","DOI":"10.3390\/cancers17030368"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2544169","DOI":"10.1080\/20002297.2025.2544169","article-title":"Microbial manipulators: Fusobacterium nucleatum modulates the tumor immune microenvironment in colorectal cancer","volume":"17","author":"Li","year":"2025","journal-title":"J. Oral Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Heregger, R., Huemer, F., Greil, R., Canadas-Ortega, M., Posselt, G., Ijsselsteijn, M.E., Plattner, C., Rieder, D., Trajanoski, Z., and Krogsdam, A. (2025). Impact of Fusobacterium nucleatum on immune cell interactions and gene expression in colorectal cancer: A retrospective cohort study. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1629014"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1016\/j.ccell.2024.08.019","article-title":"Fusobacterium nucleatum facilitates anti-PD-1 therapy in microsatellite stable colorectal cancer","volume":"42","author":"Wang","year":"2024","journal-title":"Cancer Cell"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s13027-025-00676-w","article-title":"Targeting Fusobacterium nucleatum in colorectal cancer: Therapeutic strategies and future directions","volume":"20","author":"Kowsarkhizi","year":"2025","journal-title":"Infect. Agent Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41522-025-00883-8","article-title":"Gut microbiome-driven colorectal cancer via immune, metabolic, neural, and endocrine axes reprogramming","volume":"12","author":"Bautista","year":"2026","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e70994","DOI":"10.1002\/cam4.70994","article-title":"Gut Microbiota Reshapes the Tumor Microenvironment and Affects the Efficacy of Colorectal Cancer Immunotherapy","volume":"14","author":"Wang","year":"2025","journal-title":"Cancer Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Xia, S., Ma, L., Li, H., Li, Y., and Yu, L. (2025). Prevalence of enterotoxigenic Bacteroides fragilis in patients with colorectal cancer: A systematic review and meta-analysis. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1525609"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Saito, R., Shigematsu, Y., Amori, M., Amori, G., Takamatsu, M., Nishida, K., Kanda, H., Takahashi, Y., Miura, Y., and Takeuchi, K. (2025). Association of Enterotoxigenic Bacteroides fragilis with Immune Modulation in Colorectal Cancer Liver Metastasis. Cancers, 17.","DOI":"10.3390\/cancers17172733"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/s41586-020-2080-8","article-title":"Mutational signature in colorectal cancer caused by genotoxic pks+\u00a0E. coli","volume":"580","author":"Puschhof","year":"2020","journal-title":"Nature"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Georgeson, P., Steinfelder, R.S., Harrison, T.A., Pope, B.J., Zaidi, S.H., Qu, C., Lin, Y., Joo, J.E., Mahmood, K., and Clendenning, M. (2024). Genotoxic colibactin mutational signature in colorectal cancer is associated with clinicopathological features, specific genomic alterations and better survival. medRxiv.","DOI":"10.1101\/2023.03.10.23287127"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1038\/s41586-025-09025-8","article-title":"Geographic and age variations in mutational processes in colorectal cancer","volume":"643","author":"Moody","year":"2025","journal-title":"Nature"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4200","DOI":"10.1038\/s41388-022-02395-7","article-title":"Parvimonas micra promotes colorectal tumorigenesis and is associated with prognosis of colorectal cancer patients","volume":"41","author":"Zhao","year":"2022","journal-title":"Oncogene"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e70667","DOI":"10.1002\/ctm2.70667","article-title":"Parvimonas micra promotes carcinogenesis of colorectal cancer through phenyllactic acid-induced DNA damage","volume":"16","author":"Guo","year":"2026","journal-title":"Clin. Transl. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1038\/s41522-025-00818-3","article-title":"Harnessing gut microbiota for colorectal cancer therapy: From clinical insights to therapeutic innovations","volume":"11","author":"Chen","year":"2025","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2350156","DOI":"10.1080\/19490976.2024.2350156","article-title":"Biofilms and core pathogens shape the tumor microenvironment and immune phenotype in colorectal cancer","volume":"16","author":"Kvich","year":"2024","journal-title":"Gut Microbes"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Luo, W., Li, R., Pan, C., and Luo, C. (2025). Gut microbiota-derived metabolites in immunomodulation and gastrointestinal cancer immunotherapy. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1710880"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"214","DOI":"10.21037\/tcr-2025-1992","article-title":"Targeting the gut microbiota-metabolite-immune axis in cancer immunotherapy: Mechanistic interplay, therapeutic strategies, and translational applications-a narrative review","volume":"15","author":"Huang","year":"2026","journal-title":"Transl. Cancer Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.semcancer.2025.10.005","article-title":"Microbial metabolites for cancer immunotherapy: Current evidence and future directions","volume":"117","author":"Wang","year":"2025","journal-title":"Semin. Cancer Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12943-025-02521-5","article-title":"Gut microbial metabolites in cancer immunomodulation","volume":"25","author":"Liu","year":"2025","journal-title":"Mol. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Cao, Q., Yang, M., and Chen, M. (2025). Metabolic interactions: How gut microbial metabolites influence colorectal cancer. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1611698"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Li, D., Lan, X., Xu, L., Zhou, S., Luo, H., Zhang, X., Yu, W., Yang, Y., and Fang, X. (2025). Influence of gut microbial metabolites on tumor immunotherapy: Mechanisms and potential natural products. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1552010"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Lu, Y., Yuan, H., Liang, S., Li, D., Jiang, P., Wang, X., Zhang, K., and Liu, D. (2025). Microbial metabolite-driven immune reprogramming in tumor immunotherapy: Mechanisms and therapeutic perspectives. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1603658"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zhao, H., Wang, D., Zhang, Z., Xian, J., and Bai, X. (2022). Effect of Gut Microbiota-Derived Metabolites on Immune Checkpoint Inhibitor Therapy: Enemy or Friend?. Molecules, 27.","DOI":"10.3390\/molecules27154799"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Brusnic, O., Onisor, D., Boicean, A., Hasegan, A., Ichim, C., Guzun, A., Chicea, R., Todor, S.B., Vintila, B.I., and Anderco, P. (2024). Fecal Microbiota Transplantation: Insights into Colon Carcinogenesis and Immune Regulation. J. Clin. Med., 13.","DOI":"10.3390\/jcm13216578"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1126\/science.abf3363","article-title":"Fecal microbiota transplant overcomes resistance to anti-PD-1 therapy in melanoma patients","volume":"371","author":"Davar","year":"2021","journal-title":"Science"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Lin, A., Huang, L., Jiang, A., Zhu, L., Mou, W., Li, Y., Zhang, C., Liu, Z., Zhang, J., and Cheng, Q. (2025). Microbiota boost immunotherapy? A meta-analysis dives into fecal microbiota transplantation and immune checkpoint inhibitors. BMC Med., 23.","DOI":"10.1186\/s12916-025-04183-y"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Deng, M., Li, X., Wu, H., Xue, D., Wang, Y., Guo, R., Cui, Y., Jin, C., Luo, F., and Li, H. (2025). The current status and prospects of gut microbiota combined with PD-1\/PD-L1 inhibitors in the treatment of colorectal cancer: A review. BMC Gastroenterol., 25.","DOI":"10.1186\/s12876-025-03968-y"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"189476","DOI":"10.1016\/j.bbcan.2025.189476","article-title":"Research progress on gut microbiota in colorectal cancer immunotherapy","volume":"1880","author":"Li","year":"2025","journal-title":"Biochim Biophys. Acta Rev. Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Hu, S., Luo, C., Wan, S., Zhang, S., Li, N., Liu, G., and Zhao, L.Y. (2026). Modulating the gut microbiome to enhance cancer immunotherapy: A systematic review and Meta-Analysis of probiotics and FMT as adjuncts. BMC Cancer, 26.","DOI":"10.1186\/s12885-026-15655-6"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1126\/science.abb5920","article-title":"Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients","volume":"371","author":"Baruch","year":"2021","journal-title":"Science"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Ciernikova, S., Sevcikova, A., Novisedlakova, M., and Mego, M. (2024). Insights into the Relationship Between the Gut Microbiome and Immune Checkpoint Inhibitors in Solid Tumors. Cancers, 16.","DOI":"10.3390\/cancers16244271"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3892\/ol.2024.14221","article-title":"Gut microbiota influences the efficiency of immune checkpoint inhibitors by modulating the immune system (Review)","volume":"27","author":"Jiang","year":"2024","journal-title":"Oncol. Lett."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1002\/iub.2908","article-title":"The role of the gut microbiome in modulating immunotherapy efficacy in colorectal cancer","volume":"76","author":"Zuo","year":"2024","journal-title":"IUBMB Life"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1038\/s41575-024-00901-8","article-title":"Live bacterial therapeutics for detection and treatment of colorectal cancer","volume":"21","author":"Zhang","year":"2024","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"25268","DOI":"10.1038\/s41598-025-08915-1","article-title":"Integrative analysis of multi-omics data and gut microbiota composition reveals prognostic subtypes and predicts immunotherapy response in colorectal cancer using machine learning","volume":"15","author":"Wang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"pkaf026","DOI":"10.1093\/jncics\/pkaf026","article-title":"Gut microbiome in colorectal cancer: Metagenomics from bench to bedside","volume":"9","author":"Zafarjafarzadeh","year":"2025","journal-title":"JNCI Cancer Spectr."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Carranza, F.G., Diaz, F.C., Ninova, M., and Velazquez-Villarreal, E. (2024). Current state and future prospects of spatial biology in colorectal cancer. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1513821"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"108791","DOI":"10.1016\/j.biotechadv.2025.108791","article-title":"Spatial transcriptomics: Integrating platforms and computational approaches for clinical insights","volume":"87","author":"Song","year":"2026","journal-title":"Biotechnol. Adv."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/16\/2538\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:17:27Z","timestamp":1786097847000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/16\/2538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":57,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["cancers18162538"],"URL":"https:\/\/doi.org\/10.3390\/cancers18162538","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}