Figure 4 ∣. Cancer management through the use of bacteriotherapy.

Potential strategies to enlist bacteria to prevent or treat carcinogenesis include FMT, probiotics and armed bacteria. In FMT, the carcinogenic microbiota from patients is ‘replaced’ by a new, healthy microbiota to eliminate carcinogenic activities. The introductions of probiotics may result in a ‘rebalanced’ microbiota with less potential to cause cancer. Bacteria could also be engineered to deliver specific cargo, such as cell death signalling molecules, toxins or enzymes, to selectively activate antitumour prodrugs in the tumour tissues. Whether probiotic intake results in a healthy microbiota or whether healthy microbiota prevents development of carcinogenesis (question marks) is unclear.