Researchers are exploring a novel approach to cancer treatment using fecal microbiota transplantation (FMT), often referred to as “poop pills.” Recent clinical trials suggest that these pills can not only reduce the debilitating side effects of cancer therapies but also enhance the effectiveness of immunotherapy in certain cancers.
The research, published in , in the journal Nature Medicine, involved two separate studies conducted in Canada. One trial, led by scientists at the London Health Sciences Centre Research Institute (LHSCRI) and Lawson Research Institute, focused on patients undergoing immunotherapy for kidney cancer. The study found that customized FMT may help mitigate the severe side effects – specifically colitis and diarrhea – often associated with this type of cancer treatment. “Standard treatment for advanced kidney cancer often includes an immunotherapy drug that helps the patient’s immune system tackle cancer cells,” explained Saman Maleki, PhD, a scientist at LHSCRI. “But, unfortunately, the treatment frequently leads to colitis and diarrhea, sometimes so severe that a patient must stop life-sustaining treatment early. If we can reduce toxic side effects and help patients complete their treatment, that will be a game-changer.”
The second study, conducted at the Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), investigated the impact of FMT on patients with lung cancer and melanoma receiving immunotherapy. The results were promising: reports indicated that 80% of lung cancer patients responded to immunotherapy after FMT treatment, a significant increase compared to the 39% to 45% response rate observed in patients treated with immunotherapy alone.
FMT involves transferring fecal matter, and the associated microbes, from a healthy donor into the recipient’s gastrointestinal tract. The goal is to restore a healthy gut microbiome, which plays a crucial role in immune function and overall health. The “poop pills” developed by Lawson Research Institute contain freeze-dried fecal matter, making the process more palatable and convenient than traditional FMT methods, which often involve colonoscopy or enema.
The potential benefits of FMT in cancer treatment extend beyond simply managing side effects and improving immunotherapy response. Research suggests that the gut microbiome can influence the tumor microenvironment and even augment the effectiveness of immune checkpoint inhibitors, a type of immunotherapy. A recent article published on , highlighted the potential of FMT to reprogram the tumor microenvironment, potentially making cancer cells more vulnerable to treatment.
While the findings are encouraging, it’s important to note that this research is still in its early stages. The Phase I clinical trial at LHSCRI involved only 20 patients, and further studies are needed to confirm these results in larger and more diverse populations. Researchers are also working to understand which specific microbes within the fecal matter are responsible for the observed benefits, which could lead to the development of more targeted and effective therapies.
The concept of using fecal transplants to treat disease isn’t new. FMT has been successfully used for years to treat recurrent Clostridioides difficile infection, a severe intestinal infection. The application of FMT to cancer treatment represents a significant expansion of its potential therapeutic uses. The development of these “crapsules,” as they’ve been nicknamed, could represent a significant step forward in cancer care, offering a new avenue for improving treatment outcomes and quality of life for patients.
The research team emphasizes that FMT is not a standalone cancer treatment. It is being investigated as a way to enhance the effectiveness of existing therapies, such as immunotherapy and chemotherapy, and to mitigate their associated side effects. The ultimate goal is to personalize cancer treatment based on an individual’s gut microbiome, maximizing the benefits of therapy while minimizing harm.
Further research is underway to explore the potential of FMT in other types of cancer and to optimize the process of donor selection and fecal matter preparation. The findings from these ongoing studies will be crucial in determining the long-term role of FMT in the fight against cancer.
