IMR Press / FBL / Volume 29 / Issue 4 / DOI: 10.31083/j.fbl2904152
Open Access Review
Metastasis and the Microbiome: The Impact of Bacteria in Disseminated Colorectal Cancer
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1 Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
2 Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
*Correspondence: mgwhite@mdanderson.org (Michael G. White)
Front. Biosci. (Landmark Ed) 2024, 29(4), 152; https://doi.org/10.31083/j.fbl2904152
Submitted: 4 January 2024 | Revised: 24 February 2024 | Accepted: 7 March 2024 | Published: 18 April 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Metastasis remains a leading cause of mortality for patients with solid tumors. An expanding body of literature suggests interplay between the host, gut, and tumoral microbiomes may play a role in cancer initiation and distant dissemination. These associations have been particularly well-studied in colorectal cancer, where gut dysbiosis and an endotoxin-induced inflammatory milieu foster premalignant polyp formation, setting the stage for carcinogenesis. Subsequent violation of the gut vascular barrier enables dissemination of bacterial agents to sites such as the liver, where they contribute to establishment of pre-metastatic niches, which promote tumor cell extravasation and metastatic outgrowth. Intriguingly, breakdown of this vascular barrier has been shown to be aided by the presence of tumoral bacteria. The presence of similar species, including Fusobacterium nucleatum and Escherichia Coli, in both primary and metastatic colorectal tumors, supports this hypothesis and their presence is associated with chemotherapy resistance and an overall poor prognosis. Specific gut microbial populations are also associated with differential response to immunotherapy, which has a growing role in microsatellite unstable colorectal cancers. Recent work suggests that modulation of gut microbiome using dietary modification, targeted antibiotics, or fecal microbiota transplantation may improve response to immunotherapy and oncologic outcomes. Elucidation of the precise mechanistic links between the microbiome and cancer dissemination will open the doors to additional therapeutic possibilities.

Keywords
colorectal cancer
microbiome
metastasis
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