Fecal Microbiota Transplant Shows Potential for Improved Melanoma Treatment

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By ASCO Post Staff

Posted: 2023/7/11 11:23:00 AM

Last update: 2023/11/7 2:14:47 PM

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In a phase I study published by Routy et al., researchers found that transplantation of fecal microbiota from healthy donors is safe and may improve response rates to immunotherapy in patients with advanced melanoma. I discovered something. natural medicine.

Background

Immunotherapy agents designed to stimulate the immune system to attack and destroy cancer cells can significantly improve survival outcomes for melanoma patients, but only 40% to 50% of cases are effective Only. Preliminary studies suggest that the human microbiome may play a role in therapeutic response.

“In this study, we aimed to improve patient response to immunotherapy. [boosting] Observing microbiota health through faeces [microbiota] transplant,” explained the co-authors of the study. Dr. John LenehanHe is an Associate Professor of Oncology at the Western University Schulich School of Medicine and Dentistry, a Medical Oncologist at the London Community Cancer Program and an Associate Fellow at the Lawson Institute for Health, London Health Science Centre.

Fecal microbiota transplantation involves collecting stool from a healthy donor, screening and preparing it in the laboratory, and transplanting it into the patient. The purpose of this procedure is to encourage the growth of healthy bacteria in the patient’s intestines.

“The microbiome, the immune system, and its relevance to cancer therapy are a growing area of ​​science,” emphasized the senior study author. Saman Maleki Valekhi, M.Sc., Ph.D., Assistant Professor of Oncology, Pathology and Laboratory Medicine, Medical Biophysics at the Schulich School of Medicine and Dentistry, Western University, and a Scientist at the London Regional Cancer Program at the London Health Science Centre. “This study aimed to harness microbes to improve outcomes for melanoma patients,” he added.

Research methods and results

In a new phase I trial, researchers gave 20 melanoma patients approximately 40 oral fecal microbiota transplant capsules in one session one week before the start of immunotherapy.

The researchers found that combining faecal microbiota transplantation and immunotherapy was potentially safe for patients in the study. They also found that 65% of patients who retained the donor’s fecal microbiota had a clinical response to the combination therapy. However, five of them experienced immunotherapy-related adverse events and discontinued treatment.

“Treatment of melanoma with immunotherapy has plateaued, but the microbiome may represent a paradigm shift,” stressed the study’s first author. Bertrand Luti, M.D., Ph.D., Clinical Associate Professor of Hematology and Oncology at the University of Montreal School of Medicine and Director of the Immunotherapy/Oncomicrobiome Laboratory at the University of Montreal Hospital Center. “This study shows that fecal transplantation can safely improve a patient’s response to immunotherapy, putting Canada at the forefront of microbiome research,” he suggested.

Conclusion

“These exciting results add to a rapidly growing list of publications suggesting that targeting the microbiome could represent a major advance in the use of immunotherapy for cancer patients.” and co-study authors emphasized Wilson H. Miller Jr., M.D., Ph.D.James McGill Professor of Oncology and Medicine, Director of Developmental Therapeutics at McGill University, and Associate Director of Clinical Research at the Lady Davis Medical Institute at Jewish General Hospital.

“Our group has been feces” [microbiota] After 20 years of transplants, the treatment was initially successful Clostridioides difficile Infection. This allowed us to refine our method and allow a very high percentage of donor organisms to survive in the recipient gut after just one administration. ” Dr. Michael Silverman, FRCP, FACP, AAIHIVed, Director of the Division of Infectious Diseases, Schulich School of Medicine and Dentistry, Western University; Director of Infectious Diseases, St Joseph Health Care London; Associate Fellow, Lawson Health Institute, Center for Health Sciences, London. “Our data suggest at least some of the successes we’re seeing in patients. [with melanoma] It has to do with the effectiveness of the capsule,” he pointed out.

The researchers are currently conducting a large phase II trial involving medical centers in Ontario and Quebec that will show it in the treatment of other cancer types, including renal cell, pancreatic and lung cancer. The feasibility of fecal microbiota transplantation is also being analyzed. Like people with human immunodeficiency virus or rheumatoid arthritis.

Disclosure: The work in this study was supported in part by donations from the London Health Science Foundation, Western University, the Lotte and John Hecht Memorial Foundation, the Jewish General Hospital Foundation, the Canadian Cancer Society’s Impact Grant Program, and the Terry Fox Foundation. rice field. Full disclosures of study authors are available at nature.com.

The content of this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the views or opinions of ASCO®.


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