Gut Microbiome Modulation Via Fecal Microbiota Transplant to Augment Immunotherapy in Patients with Melanoma or Other Cancers

Abstract

Purpose of Review

We review emerging evidence regarding the impact of gut microbes on antitumor immunity, and ongoing efforts to translate this in clinical trials.

Recent Findings

Pre-clinical models and human cohort studies support a role for gut microbes in modulating overall immunity and immunotherapy response, and numerous trials are now underway exploring strategies to modulate gut microbes to enhance responses to cancer therapy. This includes the use of fecal microbiota transplant (FMT), which is being used to treat patients with Clostridium difficile infection among other non-cancer indications. The use of FMT is now being extended to modulate gut microbes in patients being treated with cancer immunotherapy, with the goal of enhancing responses and/or to ameliorate toxicity. However, significant complexities exist with such an approach and will be discussed herein.

Summary

Data from ongoing studies of FMT in cancer will provide critical insights for optimization of this approach.

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Fig. 1

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Correspondence to Jennifer L. McQuade.

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Conflict of Interest

Jennifer L. McQuade has received compensation from Bristol-Myers Squibb and Merck for service as a consultant.

Gabriel O. Ologun receives funding from the National Institutes of Health (NIH) grant T32 CA 09599 and the M.D. Anderson Cancer Center support grant P30 CA016672.

Reetakshi Arora declares that she has no conflict of interest.

Jennifer A. Wargo receives research funding through grants from the American Association for Cancer Research Stand Up To Cancer, the NIH, and the Melanoma Research Alliance; has received clinical trial support from Bristol-Myers Squibb, GlaxoSmithKline, Roche/Genentech, and Novartis; has received speaker’s honoraria from Bristol-Myers Squibb, Illumina, Imedex, Omniprex, Gilead, PeerView, Physician Education Resource, Medimmune, and Exelixis; has received compensation for service as a consultant/clinical scientific advisor from Bristol-Myers Squibb, Microbiome DX, Biothera Pharma, Merck, and Dhome; has received compensation for participation on advisory boards from GlaxoSmithKline, Roche/Genentech, Novartis, and AstraZeneca; and has a patent application pending submitted by the University of Texas M.D. Anderson Cancer Center that covers methods to enhance immune checkpoint blockade responses by modulating the microbiome.

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McQuade, J.L., Ologun, G.O., Arora, R. et al. Gut Microbiome Modulation Via Fecal Microbiota Transplant to Augment Immunotherapy in Patients with Melanoma or Other Cancers. Curr Oncol Rep 22, 74 (2020). https://doi.org/10.1007/s11912-020-00913-y

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Keywords

  • Fecal microbiota transplant
  • Microbiome
  • Immunotherapy
  • Immune checkpoint blockade
  • Cancer
  • Clinical trials