Immunogenic cell death (ICD), a special form of cell death, transforms “cold” tumors into “hot” tumors by fulfilling the following three key conditions: antigenicity; adjuvanticity; and a suitable tumor microenvironment (TME). Tumor cells release damage-associated molecular patterns (DAMPs) during ICD, thereby activating the dendritic–cytotoxic T cell axis to elicit systemic antitumor immune responses. However, drug resistance and immune-related adverse effects often limit traditional ICD inducers, including chemotherapy and radiotherapy. Notably, microbiota and microbial metabolites can trigger ICD in tumor cells, leading to the release of DAMPs, modulation of immune cell functions, and TME remodeling. This study comprehensively reviews the mechanisms underlying ICD regulation via microbiota and microbial metabolites. In addition, this review examines emerging strategies, including engineered microbiota, microbial-based combination therapies (such as incorporating immune checkpoint inhibitors or chemotherapy), and dietary interventions. Despite challenges associated with individual microbiota variability and mechanistic complexity, this study highlights the potential of microbiota-mediated ICD modulation as a novel paradigm for personalized cancer therapy, thereby providing insights for future directions of scientific research.

Breast cancer mortality is driven predominantly by metastasis, which affects 20–30% of patients with early-stage disease despite guideline-directed therapies. Because conventional imaging modalities currently lack sensitivity to identify residual disease, molecular-level monitoring must be developed. Circulating tumor DNA (ctDNA) profiling currently enables transformative minimal residual disease (MRD) detection and can quantify tumor burden at low variant allele frequencies. This review provides a comprehensive overview of MRD in breast cancer, including its definition, detection technologies, positivity thresholds, pathophysiology, clinical applications in adjuvant and neoadjuvant settings, ongoing clinical trials, challenges, and future directions. ctDNA-defined MRD has potential as a precision tool for adaptive therapy, and might facilitate post-adjuvant interception, whereby targeted therapies are administered to eradicate micro-metastases before radiographic recurrence. Persistent challenges include MRD assay standardization, subtype-specific MRD thresholds, tumor heterogeneity, and positioning MRD as a potentially valuable tool for precision management in breast cancer.

Most studies on the human gut microbiome have focused on the bacterial fraction rather than fungal biomics, which as resulted in an incomplete understanding of the fungal microbiome. Recent advances in microbiota detection and next-generation sequencing technology have boosted an increase in research on fungi. Symbiotic fungi have become increasingly influential in health and disease and modulate various physiologic functions within the host. Fungal infections can result in high morbidity and mortality rates and are life-threatening in some immunocompromised patients. In addition to bacterial dysbiosis, alterations in fungal communities are important and have been linked to many diseases, including asthma, mental illness, and various cancers. When investigating cancer it is imperative to consider the role of fungi alongside viruses and bacteria. This review examined the impact of intestinal fungi and peri-tumor fungi on tumorigenesis, cancer progression, and response to anticancer therapies. The review highlights the specific involvement of some fungal species in cancers include digestive tract tumors such as colorectal, pancreatic, liver, and gastric cancers, as well as non-digestive tract tumors such as lung, melanoma, breast, and ovarian cancers. Furthermore, fungal mechanisms of action, including fungus-host recognition and immune regulation, biofilm formation, toxin and metabolite production in the tumor microenvironment, and the complex effects of fungus-bacteria interactions on tumorigenesis and development, highlight the significance of potential biomarkers in cancer diagnosis and treatment.