Hey Tim,
I will be keeping my fingers crossed that all things go well when you resume treatment!!! Here are a few reports that may interest you – more related to response and the microbiome than preventing colitis – but still…
This has lots of links within: The gut microbiome AGAIN – as it relates to immunotherapy for melanoma, other cancers, antibiotic use, and fecal transplants! ~ https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2020/08/the-gut-microbiome-again.html
This article notes that probiotics from the bottle don’t serve us as well as those attained from natural sources like yogurt, kimchi, sauerkraut, etc – and that making sure to include high fiber foods is key to a good response:
https://journals.lww.com/oncology-times/fulltext/2019/04200/gut_microbiome_affects_response_to_immunotherapy.23.aspx
And while I am hoping colitis will not be a significant problem for you, there is this:
Association of Chronic Immune-Mediated Diarrhea and Colitis With Favorable Cancer Response. Zou, Abu-Sbeih, Ma, et al. J Natl Compr Canc Netw. Dec 2020.
Background: Immune-mediated diarrhea and colitis (IMDC) is a common immune-related adverse effect related to immune checkpoint inhibitors. We aimed to identify risk factors for chronic IMDC and its prognostic value in cancer outcomes.
Methods: We retrospectively collected data on patients with a diagnosis of IMDC between January 2018 and October 2019 and grouped them based on disease duration into acute (less than or equal to 3 months) and chronic (greater than 3 months) categories. A logistic regression model and the Kaplan-Meier method with log-rank tests were used for biostatistical analysis.
Results: In our sample of 88 patients, 43 were in the chronic group and 45 were in the acute group. Genitourinary cancer and melanoma accounted for 70% of malignancies. PD-1/L1 monotherapy (52%) was the more frequently used regimen. We showed that chronic IMDC was associated with proton pump inhibitor use, long duration of IMDC symptoms and hospitalization, a histologic feature of chronic active colitis or microscopic colitis, and delayed introduction of selective immunosuppressive therapy (infliximab/vedolizumab). Chronic IMDC also reflected a better cancer response to immune checkpoint inhibitors (30% vs 51%) and was accompanied by improved overall survival. Similarly, higher doses of selective immunosuppressive therapy were associated with better overall survival.
Conclusions: Chronic IMDC can develop among patients with a more aggressive disease course and chronic features on colon histology. It likely reflects a prolonged immune checkpoint inhibitor effect and is associated with better cancer outcome and overall survival.
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Hang in there!! Celeste
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