Gut microbes metabolize capecitabine into active 5-fluorouracil, and the extent of this metabolism correlates with treatment efficacy.92,93 In addition, FOXM1 has been shown to promote HCC progression.94 Ghosh et al. compared the effects of single-agent (microbial metabolites/5-fluorouracil) and combination (microbial metabolites + 5-fluorouracil) treatment on the chemoresistant HCC cells. This evidence concerns the gene FOXM1 and hepatocellular carcinoma.