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The gut microbiome and cancer: from tumorigenesis to therapy

Nature Metabolism volume 7, pages 895–917 (2025)Cite this article

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Abstract

The gut microbiome has a crucial role in cancer development and therapy through its interactions with the immune system and tumour microenvironment. Although evidence links gut microbiota composition to cancer progression, its precise role in modulating treatment responses remains unclear. In this Review, we summarize current knowledge on the gut microbiome’s involvement in cancer, covering its role in tumour initiation and progression, interactions with chemotherapy, radiotherapy and targeted therapies, and its influence on cancer immunotherapy. We discuss the impact of microbial metabolites on immune responses, the relationship between specific bacterial species and treatment outcomes, and potential microbiota-based therapeutic strategies, including dietary interventions, probiotics and faecal microbiota transplantation. Understanding these complex microbiota–immune interactions is critical for optimizing cancer therapies. Future research should focus on defining microbial signatures associated with treatment success and developing targeted microbiome modulation strategies to enhance patient outcomes.

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Fig. 1: Gut microbiota in general, main metabolites produced and their targets.
Fig. 2: Gut microbiome-based therapies against cancer and their impact on treatments.
Fig. 3: Gut microbiota metabolites and immunity.

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Acknowledgements

B.F.J. is research director at FRS-FNRS (Fonds de la Recherche Scientifique) and P.D.C. is honorary research director at FRS-FNRS. B.F.J. and P.D.C. are the recipients of Actions de Recherches concertees-Communaute Française de Belgique no. ARC19/24–096. P.D.C. is the recipient of grants from FNRS (Projet de Recherche PDR-convention: FNRS T.0032.25, FRFS-WELBIO: WELBIO-CR-2022A-02P, EOS: programme no. 40007505). C.v.M. is supported by a postdoctoral research mandate from the Fonds de Recherche Clinique. A.N. is supported by a doctoral research mandate from the Fondation Saint-Luc.

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Author notes

  1. These authors contributed equally: Amandine Nobels, Cédric van Marcke, Bénédicte F. Jordan, Matthias Van Hul, Patrice D. Cani.

Authors and Affiliations

  1. UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium

    Amandine Nobels, Matthias Van Hul & Patrice D. Cani

  2. UCLouvain, Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), Pole of Medical Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium

    Amandine Nobels & Cédric van Marcke

  3. Department of Medical Oncology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium

    Cédric van Marcke

  4. Breast Clinic, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium

    Cédric van Marcke

  5. UCLouvain, Université catholique de Louvain, Biomedical Magnetic Resonance group (REMA), Louvain Drug Research Institute (LDRI), Brussels, Belgium

    Bénédicte F. Jordan

  6. Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WELBIO department, WEL Research Institute, Wavre, Belgium

    Matthias Van Hul & Patrice D. Cani

  7. UCLouvain, Université catholique de Louvain, Institute of Experimental and Clinical Research (IREC), Brussels, Belgium

    Patrice D. Cani

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Contributions

A.N., C.v.M., B.F.J., M.V.H. and P.D.C. conceived and designed the Review. P.D.C. coordinated and supervised the Review. A.N., C.v.M., B.F.J., M.V.H. and P.D.C. performed the literature review. A.N., C.v.M., B.F.J., M.V.H. and P.D.C. conducted the writing. M.V.H. prepared the figures. A.N., C.v.M., B.F.J., M.V.H. and P.D.C reviewed the final draft. All authors discussed the Review, reviewed the revised versions, commented on the manuscript and figures before submission, and agreed with the final submitted manuscript.

Corresponding authors

Correspondence to Matthias Van Hul or Patrice D. Cani.

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Competing interests

P.D.C. and B.F.J. are inventors on patent applications dealing with the use of gut bacteria and their components in the treatment of diseases. P.D.C. was a co-founder of The Akkermansia Company and Enterosys. The remaining authors declare no competing interests.

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Nobels, A., van Marcke, C., Jordan, B.F. et al. The gut microbiome and cancer: from tumorigenesis to therapy. Nat Metab 7, 895–917 (2025). https://doi.org/10.1038/s42255-025-01287-w

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