Recent research led by Wei Wei and Diwei Zheng at the Institute of Process Engineering highlights Fusobacterium nucleatum (Fn) as a major driver in colorectal cancer (CRC) progression. This oral anaerobic bacterium, while typically absent in healthy lower gastrointestinal tracts, colonizes colorectal environments during disease states, promoting tumor initiation, progression, metastasis, and therapy resistance. The study delves into Fn’s multifaceted pathogenic mechanisms involving virulence factors such as FadA, Fap2, and RadD that activate oncogenic pathways and alter immune responses. Various therapeutic strategies targeting Fn have been assessed, including antibiotics, natural extracts, nanomedicines, and biopharmaceuticals like antimicrobial peptides and phages. Despite promising preclinical data, challenges such as off-target effects and microbiome disruption persist, underscoring the need for precision interventions in CRC management that focus on specific, low-toxicity approaches.