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The past decade has led to major advances into how the microbiome impacts health and disease. It is clear the microbiome can impact all aspect of human physiology. The is a large battery of data which demonstrates that microbes impact tumor biology. This session will highlight how the gut microbiome impacts tumor initiation and progression. Moreover, we highlight how the gut microbiome can also determine response to cancer therapies and predict disease progression and survival. Lastly we will emphasize how the microbiome can be utilized as adjuvant therapy to increase the efficacy of chemo and immune-based therapies.