Cancer treatment reviews
July 7, 2026 · via Europe PMC
Fusobacterium nucleatum and response to treatment in colon and rectal cancer: a systematic review.
De Dosso S, Deantonio L, Iezzi G, Christoforidis D, Vannelli A, Frattini M, Garo ML.
AI summary — for doctors, generated from the abstract only
Higher Fusobacterium nucleatum abundance is consistently linked to worse treatment response across colorectal cancer settings, but the evidence quality is low to very low.
What was studied
A PRISMA systematic review of 11 studies (1,571 patients) on whether F. nucleatum before or during treatment is associated with response and survival outcomes in colorectal cancer.
Key findings
- In locally advanced rectal cancer, 4 of 5 studies linked higher pre-treatment Fn to poorer pathological response to neoadjuvant chemoradiotherapy
- Persistent Fn positivity after treatment was linked to higher relapse risk
- In metastatic CRC on immunotherapy, 2 studies found Fn enriched in non-responders, while 1 found better outcomes in Fn-positive tumours on PD-L1 blockade
- In chemotherapy-treated metastatic CRC, Fn was higher in patients with progressive disease
- Evidence quality was rated low to very low
Clinical relevance
This suggests Fn could become a predictive biomarker or therapeutic target. Given the small, heterogeneous and low-quality evidence base, it is not ready for clinical decision-making.
Who should care
Limitations
Few studies with heterogeneous Fn assays and outcomes; no meta-analysis; evidence quality low to very low.
Gut bacterium F. nucleatum may mark treatment-resistant colorectal cancer, but prospective studies are needed.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Fusobacterium nucleatum (Fn) has been implicated in the progression of colorectal cancer (CRC), immune modulation, and resistance to systemic therapies. However, its role as a predictive biomarker of treatment response remains unclear. We conducted a systematic review to evaluate the association between Fn and oncologic treatment outcomes in CRC.
Methods
This systematic review was performed according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD420261327958). MEDLINE, Scopus, and CENTRAL were searched through March 2026. Eligible studies included adult CRC patients with Fn assessment performed before or during treatment and reporting treatment-related outcomes. Primary endpoints included pathological complete response (pCR), tumour regression grade (TRG), and objective response rate (ORR). Secondary endpoints included disease-free survival (DFS), relapse-free survival (RFS), progression-free survival (PFS), and overall survival (OS).
Results
Eleven studies including 1571 patients, were analysed. In locally advanced rectal cancer, four of five studies indicated that higher pre-treatment Fn abundance was associated with poorer pathological response to neoadjuvant chemoradiotherapy. Persistent Fn positivity after treatment was linked to an increased relapse risk. In metastatic CRC receiving immunotherapy, two studies reported enrichment of Fn in non-responders, while one study observed improved outcomes in Fn-positive tumours treated with PD-L1 blockade. In chemotherapy-treated metastatic CRC, Fn abundance was significantly higher in patients with progressive disease. Overall, the quality of evidence was rated low to very low.
Conclusions
Fn appears to be associated with treatment resistance across multiple CRC settings and may represent a promising biomarker and therapeutic target. Prospective biomarker-driven studies are warranted.
DOI
10.1016/j.ctrv.2026.103182
PMID
42435617
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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