And fecal transplant It is a medical procedure in which fecal material from a healthy donor is transferred to the intestine of a diseased recipient with the aim of restoring or modifying the composition of the recipient’s intestinal microbiota. With more and more studies carried out on its implications in the treatment of various pathologies, this time it has been tested in the context of one of the most lethal cancers, melanoma.
Thus, the first clinical trial carried out in the world on this relationship, it has been discovered that the fecal microbiota transplants (FMT) from healthy donors are safe and promise to improve the response to immunotherapy in patients with advanced melanoma, as corroborated by the results of a multicenter study from the Lawson Health Research Institute, the Center hospitalier de l’Université de Montréal (CHUM) and the Jewish General Hospital (JGH) published in the magazine Nature Medicine.
Los immunotherapy drugs stimulate a person’s immune system to attack and destroy cancer. While they can significantly improve survival outcomes in people with melanoma, they are only effective in 40 to 50 percent of patients. Preliminary research has suggested that the human microbiome, the diverse collection of microbes in our bodies, may play a role in whether or not a patient responds.
“In this study, our goal was to improve the response of melanoma patients to immunotherapy by improving the health of their microbiome through fecal transplants,” says Dr. Dr. John LenehanLondon Health Sciences Center’s (LHSC) Medical Oncologist, Scientist and Associate Professor in the Department of Oncology, Western University Schulich School of Medicine.
“The connection between the microbiome, the immune system, and cancer treatment is a growing scientific field,” explains Dr. Dr. Saman Maleki, Lawson scientist and LHSC’s LRCP, assistant professor in Schulich Medicine’s departments of oncology, pathology and laboratory medicine, and medical biophysics, and principal investigator of the study. “This study aimed to harness microbes to improve outcomes for patients with melanoma.”
Healthy microbes to boost immunotherapy against melanoma
The phase I trial included 20 melanoma patients recruited from LHSC, CHUM, and Jewish General Hospital. Patients were administered approximately 40 fecal transplant capsules orally during a single session, one week before starting immunotherapy treatment.
The study found that the combination of fecal transplants with immunotherapy is safe for patients, which is the main goal of a phase I trial. The study also found that 65% of patients who preserved the donor microbiome had a response combination treatment clinic. Five patients experienced adverse events sometimes associated with immunotherapy and their treatment was discontinued.
“We have reached a plateau in the treatment of melanoma with immunotherapy, but the microbiome has the potential to be a paradigm shift,” says Dr. Dr. Bertrand Routy, oncologist and director of the CHUM Microbiome Center. “This study places Canada at the forefront of microbiome research by demonstrating that we can safely improve patients’ response to immunotherapy through fecal transplantation.”
“These exciting results add to a rapidly growing list of publications suggesting that targeting the microbiome may provide a breakthrough in the use of immunotherapy for our cancer patients,” added Dr. Dr. Wilson H. Miller Jr. of the JGH and Professor in the Departments of Medicine and Oncology at McGill University.
The study is unique because of its administration of fecal transplants (from healthy donors) in capsule form to cancer patients, a technique pioneered in London by Lawson Scientist, Dr. Michael Silverman, Chairman of Infectious Diseases at Schulich. Medicine and Medical Director of the Infectious Care Program at St. Joseph’s Health Care London.
“Our group has been doing fecal transplants for 20 years, and was initially successful in treating C. difficile infections. This has allowed us to refine our methods and provide an exceptionally high rate of donor microbes surviving in the recipient. intestine with a single dose,” says Dr. Silverman. “Our data suggest that at least part of the success we are seeing in melanoma patients is related to the efficacy of the capsules.”
The team has already begun a larger phase II trial involving centers in Ontario and Quebec. Lawson researchers are also studying the potential of fecal transplants in the treatment of other types of cancerincluding renal cell carcinoma, pancreatic cancer, and lung cancer, as well as HIV and rheumatoid arthritis.
Fuente: Lawson Health Research Institute