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The effect of a drug, or impact of a treatment like chemotherapy, doesn’t just depend on your body. The success of a particular medicine also depends on the trillions of bacteria in your gut.
The 100 trillion bacteria that live within the human digestive tract – known as the human gut microbiome – help us extract nutrients from food, boost the immune response and modulate the effects of drugs……..
Following this fecal microbe transplant treatment, tumors of six out of 15 patients in the study had tumors that shrank or remained the same. The treatment was well tolerated, though some of the patients experienced minor side effects including fatigue.
When we analyzed the gut microbiota of treated patients, we observed that the six patients whose cancers had stabilized or improved showed increased numbers of bacteria that had previously been associated with responses to immunotherapy.
My colleagues and I also analyzed the blood and tumors from responders. In doing so, we observed that the responders had lower levels of adverse immune cells termed myeloid cells, and higher levels of memory immune cells. Additionally, by analyzing proteins in the blood serum of treated patients, we observed reductions in levels of key immune system molecules associated with resistance in responders.
These results suggest that introducing certain intestinal microorganisms into a patient’s colon may help the patient respond to drugs that enhance the immune system’s ability to recognize and kill tumor cells.
Ultimately we hope to move beyond fecal microbe transplants to specific collections of microbes in cancers besides melanoma, paving the way for standardized microbe-based drug therapy to treat immunotherapy-resistant tumors.
Diwakar Davar, Assistant Professor of Medicine, University of Pittsburgh.
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