From ecosystem engineering to living computers: integrating dual-paradigm bacterial therapeutics for solid tumor...

Recent advances in tumor microbiome biology and synthetic biology have made bacteria attractive therapeutic agents capable of reprogramming tumor-associated microbial ecosystems and serving as programmable living systems in solid tumors. In this review, we construct a dual-paradigm framework combining engineered bacterial therapeutics and ecosystem editing. In the first paradigm, phage-mediated targeting, competitive displacement, and metabolic reprogramming are used to alter tumor-associated microbial communities. In the second paradigm, engineered bacteria are equipped with environmental sensors, genetic logic circuits, and therapeutic payloads. We discuss the mechanistic interplay of these strategies in terms of ecological niche formation, bacterial colonization, immune and metabolic remodeling, and microbiome-host feedback. Clinical experience still varies across platforms due to differences in bacterial strain, attenuation, route of administration, tumor biology, treatment context, and patient characteristics. Major translational challenges include biocontainment, genetic stability, manufacturing and potency control, predictive biomarker validation, and product-specific regulatory requirements. We propose an additional hypothesis-generating framework for patient stratification and adaptive treatment monitoring. These concepts together provide a structured framework for exploring bacterial therapeutics as components of precision oncology, while highlighting the need for prospective clinical validation.