Zheng Y, Liu DR, Ma J, Tan WB. Longitudinal dynamics of the gut microbiota during colorectal cancer treatment: Insights and implications for therapy. World J Gastroenterol 2026; 32(40): 120855 [DOI: 10.3748/wjg.120855]
Corresponding Author of This Article
Wen-Bin Tan, PhD, Professor, School of Basic Medical Sciences, Jining Medical University, No. 133 Hehua Road, Jining 272067, Shandong Province, China. 1392144@163.com
Research Domain of This Article
Microbiology
Article-Type of This Article
editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Zheng Y, Liu DR, Ma J, Tan WB. Longitudinal dynamics of the gut microbiota during colorectal cancer treatment: Insights and implications for therapy. World J Gastroenterol 2026; 32(40): 120855 [DOI: 10.3748/wjg.120855]
World J Gastroenterol. Oct 28, 2026; 32(40): 120855 Published online Oct 28, 2026. doi: 10.3748/wjg.120855
Longitudinal dynamics of the gut microbiota during colorectal cancer treatment: Insights and implications for therapy
Yang Zheng, Dong-Rui Liu, Jian Ma, Wen-Bin Tan
Yang Zheng, Jian Ma, Department of Hepatobiliary Surgery, Jining Public Health Medical Center, Jining 272100, Shandong Province, China
Dong-Rui Liu, Pediatric Science Major of Clinical Department, Jining Medical University, Jining 272067, Shandong Province, China
Wen-Bin Tan, School of Basic Medical Sciences, Jining Medical University, Jining 272067, Shandong Province, China
Author contributions: Zheng Y revised the manuscript; Liu DR wrote the original draft; Ma J designed the manuscript concept; Tan WB finalized and submitted the manuscript.
Supported by China Association of Higher Education, No. 25DF0314; and JNMU College Student Innovation and Entrepreneurship Training Program, No. cx2024252.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Wen-Bin Tan, PhD, Professor, School of Basic Medical Sciences, Jining Medical University, No. 133 Hehua Road, Jining 272067, Shandong Province, China. 1392144@163.com
Received: March 10, 2026 Revised: April 14, 2026 Accepted: April 27, 2026 Published online: October 28, 2026 Processing time: 185 Days and 2.4 Hours
Abstract
The gut microbiota plays a pivotal role in the pathogenesis of colorectal cancer (CRC) and its response to treatment. The longitudinal study by Le et al published in the World Journal of Gastroenterology provides unprecedented insights into Vietnam-specific temporal dynamics of gut microbial communities in Vietnamese patients with CRC undergoing surgery and chemotherapy. By profiling fecal samples at diagnosis, after surgery, and after completing chemotherapy, the authors demonstrate three signature Vietnam-distinct alterations: (1) Sustained Bacteroidaceae dominance despite diversity loss; (2) Depletion of diet-adapted taxa (Eubacterium ruminantium and Ruminococcus gauvreauii groups); and (3) Chemotherapy-driven Klebsiella expansion linked to traditional rice-based dietary patterns. Notably, alpha diversity progressively declined following surgical and chemotherapeutic interventions, accompanied by the loss of both CRC-associated pathogens and beneficial short-chain fatty acid-producing bacteria. Specifically in Vietnamese cohorts, this dysbiosis manifested: (1) Persistent sulfate-reducing Desulfovibrio populations directly linked with fermented seafood consumption; and (2) Differential resilience patterns in carbohydrate-utilizing commensals reflecting regional dietary adaptations. These Vietnam-distinct dynamics – catastrophic depletion of starch-adapted Ruminococcus gauvreauii (> 90%) and persistent Desulfovibrio colonization (68% prevalence) – define a regional dysbiotic phenotype demanding diet-integrated interventions. This editorial contextualizes these observations within the broader framework of microbiota-oncology interactions, discusses the mechanistic implications of treatment-induced dysbiosis, and explores future directions for microbiome-directed interventions in CRC management.
Core Tip: The gut microbiota experiences significant perturbations during colorectal cancer (CRC) treatment, with surgery and chemotherapy collectively reducing microbial diversity and depleting both pathogenic and beneficial bacterial taxa. These longitudinal changes, characterized by the loss of short-chain fatty acid-producing bacteria and the transient suppression of CRC-associated pathogens, have important implications for treatment efficacy, toxicity, and recovery. Understanding these temporal dynamics provides a rational foundation for developing microbiota-targeted interventions to optimize therapeutic outcomes in CRC management.
