The intratumoral microbiota: friend or foe?

The intratumoral microbiota has been recently identified as important in cancer evasion strategies. It can induce DNA damage, favor the epithelial–mesenchymal transition, inactivate drugs, polarize the immune system toward a protumorigenic profile, induce vascular reshaping and favor metastasis formation, and protect tumor cells from fluid shear stress during cell migration. However, recently also some positive effects of the intratumoral microbiota have been highlighted such as the activation of bacterial antigen-specific responses that could be harnessed to broaden not only the immune response to tumor antigens, but also the polarization of antitumorigenic responses. As in the gut, it is likely that the ratio between symbionts and pathobionts affects the outcome. More research is needed in this field to better understand this dual role.