Gut Microbiota-Adversary or Ally? Its Role and Significance in Colorectal Cancer Pathogenesis, Progression, and Treatment

Simple Summary In 2022, colorectal cancer (CRC) ranked third globally among diagnosed malignancies. Treatment typically involves a multimodal approach based on surgery and systemic chemotherapy. The human gut microbiota, comprising over 35,000 bacterial species, is heavily influenced by diet, impacting food absorption and inflammation development. Dysbiosis in the gut microbiota is strongly linked to CRC development. Recent findings suggest that the gut microbiome has a role in modulating cancer treatment effectiveness and toxicity. Therapeutic strategies like probiotics show promise in CRC treatment. This review aims to describe the current state of knowledge regarding the involvement of gut microbiota in CRC pathogenesis and its potential therapeutic implications in treating this disease, emphasizing emerging interventions.Abstract In 2022, colorectal cancer (CRC) was the third most prevalent malignancy worldwide. The therapeutic approach for CRC typically involves a multimodal regimen. The human gut microbiota comprises over 35,000 bacterial species. The composition of the gut microbiota is influenced by dietary intake, which plays a crucial role in food absorption, nutrient extraction, and the development of low-grade inflammation. Dysbiosis in the gut microbiota is a key driver of inflammation and is strongly associated with CRC development. While the gut microbiome influences CRC initiation and progression, emerging evidence suggests a role for the gut microbiome in modulating the efficacy and toxicity of cancer treatments. Therapeutic strategies targeting the gut microbiome, such as probiotics, hold promise as effective interventions in the modern therapeutical approach to CRC. For example, Microbiota Implementation to Reduce Anastomotic Colorectal Leaks (MIRACLe) implementation has resulted in improvements in clinical outcomes, including reduced incidence of anastomotic leakage (AL), surgical site infections (SSIs), reoperation, as well as shorter recovery times and hospital stays compared with the control group. Therefore, this review aims to describe the current state of knowledge regarding the involvement of the gut microbiota in CRC pathogenesis and its potential therapeutic implications to treat CRC.