Synbiotics as a Microbiome-Based Strategy in Colorectal Cancer

Colorectal cancer (CRC) is a multifactorial disease arising from dynamic interactions between gut microbiota, inflammatory processes, metabolic reprogramming, and dysregulated host signaling pathways. Increasing evidence highlights the potential of synbiotics-combinations of probiotics and prebiotics-as promising modulators of these processes. This review explores the mechanisms by which synbiotics influence CRC development and progression, integrating data from preclinical and clinical studies. Synbiotics exert beneficial effects by restoring microbial balance, enhancing the production of short-chain fatty acids (SCFAs), strengthening intestinal barrier integrity, and reducing chronic inflammation and oxidative stress. These functional changes converge on key molecular pathways, including Wnt/β-catenin, NF-κB, and PI3K/Akt/mTOR, which regulate tumor cell proliferation, survival, and immune responses. Preclinical studies consistently demonstrate anti-tumor effects, including reduced tumor growth, increased apoptosis, and modulation of the tumor microenvironment. Clinical evidence suggests that synbiotics may improve postoperative outcomes, reduce chemotherapy-related toxicity, and positively influence microbiome composition, although results remain heterogeneous. Emerging approaches focusing on microbiome profiling and personalized synbiotic interventions offer new opportunities for precision medicine in CRC. Overall, synbiotics represent a promising adjunctive strategy in colorectal cancer management, with potential to enhance therapeutic efficacy and improve patient outcomes. Further large-scale clinical studies are needed to validate their long-term benefits and establish standardized treatment protocols.