Abstract
Significant advances have been made in the past decade across the melanoma care continuum, with approved systemic therapy for patients with advanced disease as well as in the adjuvant setting. We are gaining an appreciation of the factors that drive response and resistance to these therapies, and there is novel evidence that the microbiome (which refers to the microbes that inhabit our bodies along with their collective genomes) may shape overall immunity and may even impact therapeutic responses (e.g., immune checkpoint blockade). This has profound implications and calls to question if the microbiome could be used as a biomarker or therapeutic target in patients going onto treatment with immune checkpoint blockade (and potentially onto other forms of therapy). Insights are also being gained into the potential influence of the microbiota on melanoma development at the level of the skin and of the gut, though there is a tremendous knowledge yet to be gained. Each of these aspects will be discussed herein, as will strategies to target and factors that influence the microbiome.
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Author Contributions
Conception: Hermann and Wargo
Writing: Arora and Wargo
Creation of figures: Arora and Wargo
Critical review and revision of the manuscript: All authors
Conflict of Interest Disclosures
J. Wargo is an inventor on a US patent application (PCT/US17/53.717) submitted by the University of Texas MD Anderson Cancer Center that covers methods to enhance immune checkpoint blockade responses by modulating the microbiome. J. Wargo is a paid speaker for Imedex, Dava Oncology, Omniprex, Illumina, Gilead, MedImmune, and Bristol-Myers Squibb. She is a consultant/advisory board member for Roche-Genentech, Novartis, AstraZeneca, GlaxoSmithKline, Bristol-Myers Squibb, Merck, and MicrobiomeDx. J. Wargo also receives clinical trial support from GlaxoSmithKline, Roche-Genentech, Bristol-Myers Squibb, and Novartis. J. Wargo is a clinical and scientific advisor at MicrobiomeDx and a consultant at Biothera Pharma and Merck Sharp and Dohme.
The other authors declared no conflicts of interest.
Funding/Support
J. Wargo has honoraria from speakers’ bureau of Dava Oncology, Bristol-Myers Squibb, and Illumina and is an advisory board member for GlaxoSmithKline, Novartis, and Roche-Genentech. J. Wargo is supported by the NIH (1 R01 CA219896-01A1), US-Israel Binational Science Foundation (201332), Kennedy Memorial Foundation (0727030), the Melanoma Research Alliance (4022024), American Association for Cancer Research Stand Up To Cancer (SU2C-AACR-IRG-19-17), Department of Defense (W81XWH-16-1-0121), MD Anderson Cancer Center Multidisciplinary Research Program Grant, Andrew Sabin Family Fellows Program, and MD Anderson Cancer Center’s Melanoma Moon Shots Program. J. Wargo is a member of the Parker Institute for Cancer Immunotherapy at MD Anderson Cancer Center.
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Arora, R., Hermann, A., Wargo, J.A. (2019). Microbiome and Melanoma. In: Fisher, D., Bastian, B. (eds) Melanoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7322-0_41-1
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