Microbiome as a predictive biomarker in locally advanced rectal cancer

The incidence of locally advanced rectal cancer (LARC) among young people is rising alarmingly. In recent years, new protocols have been introduced for the management of LARC, some of which are associated with the risk of significant toxicity. Despite these advancements, robust predictive biomarkers for LARC have yet to be established. The microbiome has emerged as a potential biomarker due to its interaction with tumor multiomics. This article provides a critical overview of the current evidence on the microbiome and LARC, including its relationship with the immune system and epigenomics, and also highlights both the current limitations and future perspectives in the field.