REVIEW article
Front. Oncol.
Sec. Molecular and Cellular Oncology
The Pathogen's Playbook in Cancer: From Oncogenesis to Progression
Provisionally accepted
Hongzhou Cai1
Ruizi Wang2
Shaozhe Yang2Ruixin Li2Yihan Liu2Ruzhou Chen2Ziwei Li2Jinzhou Zheng2
Xuan Sun2*Guoren Zhou3- 1Jiangsu Cancer Hospital Department of Urologic Surgery, Nanjing, China
- 2Fourth School of Clinical Medicine, Nanjing Medical Universtiy, Nanjing, China
- 3Jiangsu Cancer Hospital Department of Oncology, Nanjing, China
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Globally, around 15–20% of cancers are linked to microbial infections, involving viruses, bacteria, and fungi, each with distinct pathogenic features. Advanced multi-omics technologies have confirmed tumor-specific microbial communities within tumor tissues. This review categorizes microbes by their action mechanisms in cancer biology: one group (e.g., Helicobacter pylori, HPV, Aspergillus species) directly induces tumorigenesis via DNA damage, repairing pathway disruption, oncoprotein expression, and carcinogenic metabolite production; the other group (e.g., Fusobacterium nucleatum, HIV, Candida albicans) modulates tumor progression by regulating the tumor microenvironment, enhancing tumor cell chemoresistance, or suppressing anti-tumor immunity. Additionally, this review also explores clinical translation potential, highlights research challenges, and proposes future directions to support precision oncology advancement.
Keywords: Cancer, clinical translation, Direct oncogenic mechanisms, DNA Damage, Immune Evasion, microorganisms, Tumor Microenvironment, Tumor progression regulation
Received: 01 Nov 2025; Accepted: 19 Dec 2025.
Copyright: © 2025 Cai, Wang, Yang, Li, Liu, Chen, Li, Zheng, Sun and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuan Sun
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.