Antibiotics counteracting tumor-promoting dysbiosis in colorectal cancer.

Pulsed, anaerobe-directed metronidazole combined with anti-PD-1 and a VEGF receptor inhibitor improved progression-free survival in Fusobacterium nucleatum-positive microsatellite-stable metastatic colorectal cancer.

• Why it matters: Antibiotics can undermine immune checkpoint blockade, and dysbiosis linked to tumor progression remains a challenge to treat without broadly disrupting gut ecology.
• What they did: Jiang et al. tested a regimen using pulsed metronidazole directed at anaerobes, paired with anti-PD-1 and a VEGF receptor inhibitor in Fusobacterium nucleatum-positive microsatellite-stable metastatic colorectal cancer.
• The result: The combination produced encouraging progression-free survival while selectively dismantling a pathobiont network and avoiding global dysbiosis, supporting a targeted antibiotic strategy alongside immunotherapy.

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