Date of Publication :February 2026

Abstract: Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide, with therapeutic efficacy frequently constrained by drug resistance, immune evasion, and systemic toxicity. A growing body of evidence highlights the gut microbiome and phageome as critical modulators of colorectal carcinogenesis, tumor progression, and responsiveness to therapy. This review presents a systematic integrative synthesis of gut microbiome-based therapeutics for CRC, with particular emphasis on bacteria- and bacteriophage-driven interventions. We have consolidated mechanistic and translational evidence on bacterial strategies including fecal microbiota transplantation (FMT), probiotic and synbiotic formulations, and engineered live biotherapeutic products (LBPs), alongside emerging bacteriophage-based approaches enabling precision targeting of CRC-associated pathobionts. Combinatorial bacteria–phage strategies and the role of multi-omics and artificial intelligence in guiding personalized microbiome-centred therapies are also examined. By bridging microbiology, immuno-oncology, and translational medicine, this review provides a structured framework for understanding how microbiome modulation can enhance therapeutic outcomes in CRC, while identifying key challenges and future directions for clinical translation.

Index Terms : Bacteriophage therapy, colorectal cancer, fecal microbiota transplantation, gut dysbiosis, gut microbiome, live biotherapeutic products, probiotics, tumor microenvironment.

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