Nanodrug-based therapeutic interventions for tumor-associated microbiota modulation

The tumor microenvironment (TME) is a complex and dynamic ecosystem that significantly influences tumor progression, immune modulation, and therapeutic response. A key component of the TME is the tumor-associated microbiota, which has emerged as an important player in cancer biology, affecting tumor metastasis, immune evasion, and resistance to treatments. The recent advent of high-throughput sequencing technologies has revolutionized our understanding of the microbiome, revealing distinct microbial communities across various tumor types. These microbes engage in bidirectional interactions with tumor cells and the immune system, shaping the inflammatory milieu and immune responses that ultimately influence tumor outcomes. Consequently, manipulating tumor-associated microbiota has become an exciting strategy to enhance cancer therapy. By harnessing tailored physicochemical properties and structural design, nanotechnology-based drug platforms can precisely remove tumor-associated microbiota and microbial communities within the TME, while simultaneously delivering antimicrobials, immunomodulators, or probiotics to boost immune responses and overcome resistance. However, the complexity and heterogeneity of the microbiome and TME present significant challenges in the development of universal therapeutic approaches. This review highlights the role of tumor-associated microbiota in tumor biology, the mechanisms by which microbiota influence tumor progression and therapeutic resistance, and the potential of nanodrug-based strategies for microbiome modulation in cancer treatment. By elucidating these mechanisms, we aim to provide insights into the therapeutic potential of microbiome-targeted therapies for precision oncology.