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Diet plays a central role in shaping gut microbiota composition, influencing the immune system and overall host health. Plant-based diets and the Mediterranean diet promote health-associated microbial communities that increase the production of several metabolic-end products, including short-chain fatty acids that support mucosal barrier integrity, anti-inflammatory effects, and modulation of the immunity of the host. Conversely, Western dietary patterns promote cancer progression and negatively impact the response to standard treatments. Furthermore, gut microbiota influences the effectiveness of cancer therapies, including chemotherapy, radiotherapy and, mainly, immunotherapy. Modulating microbial species, their metabolites, or their activities in the cancer microenvironment through dietary interventions, common or engineered probiotics, prebiotics, postbiotics, antibiotics or fecal microbial transplant are emerging as promising strategies for cancer prevention and tailored management in survivorship. In this review, we explore the intricate interplay between diet, gut microbiota, and cancer, focusing on how specific microbial communities\u2019 impact therapeutic outcomes, and the challenges in the modulation of the microbiota environment through several interventions, including diet. This emerging paradigm paves the way for integrating nutrition and microbiota-targeted strategies as innovative tools in the context of precision medicine.<\/jats:p>","DOI":"10.3390\/nu17172898","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T10:29:07Z","timestamp":1757327347000},"page":"2898","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The Microbiota\u2013Diet\u2013Immunity Axis in Cancer Care: From Prevention to Treatment Modulation and Survivorship"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6593-0054","authenticated-orcid":false,"given":"Sabrina","family":"Tini","sequence":"first","affiliation":[{"name":"Department of Health Science, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Baima","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Pigni","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Antoniotti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-9343","authenticated-orcid":false,"given":"Marina","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Piemonte Orientale, 28100 Novara, Italy"},{"name":"Unit of Endocrinology, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Palma","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Cerbone","sequence":"additional","affiliation":[{"name":"Mesothelioma, Melanoma and Rare Cancer Unit, Azienda Ospedaliera Universitaria SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6843-3369","authenticated-orcid":false,"given":"Federica","family":"Grosso","sequence":"additional","affiliation":[{"name":"Mesothelioma, Melanoma and Rare Cancer Unit, Azienda Ospedaliera Universitaria SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1103-6223","authenticated-orcid":false,"given":"Marta","family":"La Vecchia","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4320-1203","authenticated-orcid":false,"given":"Elisa","family":"Bona","sequence":"additional","affiliation":[{"name":"Department for Sustainable Development and Ecological Transition, Universit\u00e0 del Piemonte Orientale, 13100 Vercelli, Italy"},{"name":"Center for Translational Research on Autoimmune and Allergic Diseases, University of Piemonte Orientale, 28100 Novara, Italy"},{"name":"Simple Departmental Structure Research Laboratories-Integrated Activities Research and Innovation Department, Azienda Ospedaliera SS. 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