This study investigates advanced-stage cancer, focusing on non-small cell lung cancer, triple-negative breast cancer, colorectal cancer, and pancreatic cancer. It also includes healthy subjects at varying risks for colorectal cancer.

The study evaluates the microbiome's role and potential biomarkers in cancer treatment, focusing on how gut microbiome composition affects the immune system and treatment effectiveness.

• Who can participate: Men and women aged 18 or older with stage III or IV cancer (specific types) or healthy individuals undergoing colonoscopy. Participants must be able to provide informed consent.
• Study details: Participants will provide blood and stool samples over two years. Some participants will also provide colon tissue samples during routine care procedures. A placebo is not used in this study.
• Study timelines: The study will last 2 years for sample collection, with health records reviewed for up to 8 years.