Exploring the therapeutic potential of bacteriophage-mediated modulation of gut microbiota towards colorectal cancer

Abstract

Objectives: Given a strong association between gut dysbiosis and colorectal cancer (CRC), this review aims to explore the potential of phage therapy as a targeted intervention that can selectively eliminate CRC-associated bacteria and restore a healthy gut microbiota.

Methods: A comprehensive literature search was conducted in Web of Science, PubMed, and Google Scholar to identify studies published within the last decade relevant to gut microbiota, phage therapy, and colorectal cancer (CRC). The search strategy employed the following keywords and Boolean combinations: "gut microbiota" AND "colorectal cancer"; "gut microbiota" AND "phage therapy"; "phage therapy"; "phage therapy" AND "colorectal cancer"; "gut dysbiosis" AND "colorectal cancer"; and "gut microbial modulation" AND "colorectal cancer."

Results: Tailored phage-based strategies, such as phage cocktails and Fecal Microbial Transplantation (FMT), have demonstrated therapeutic potential in modulating disease-associated microbiota. However, the clinical application of FMT is limited by safety concerns, particularly the risk of transferring intact bacteria with pathogenic potential. In this review, we highlight Fecal Viral Transplantation (FVT) as a promising and safer alternative, where filtered fecal samples containing phages are transferred, eliminating intact bacteria that could otherwise cause adverse effects.

Conclusions: Phage therapy represents a promising strategy to modulate gut microbiota and improve CRC treatment by selectively targeting CRC-associated bacteria. However, its clinical translation in the context of CRC remains dependent on further experimental and clinical studies to establish its safety and efficacy to patients.

Keywords: Colorectal cancer (CRC); Fecal viral transplantation (FVT); Gut dysbiosis; Gut virome; Phage therapy.