Fecal microbiota transplants (FMT) may play a significant role in improving cancer treatment outcomes, according to two new studies published in Nature Medicine. The research highlights the potential for FMT capsules to reduce toxic side effects of kidney cancer treatments and enhance the effectiveness of immunotherapy in patients with lung cancer and melanoma.
The FMT capsules used in these studies were developed at Lawson Research Institute (Lawson) of St. Joseph's Health Care London. Clinical trials were conducted at London Health Sciences Centre Research Institute (LHSCRI) and Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM).
A Phase I clinical trial led by scientists at LHSCRI and Lawson evaluated whether FMT is safe when combined with an immunotherapy drug for kidney cancer. The trial included 20 patients from the Verspeeten Family Cancer Centre at London Health Sciences Centre (LHSC). Researchers found that customized FMT could help reduce toxic side effects associated with immunotherapy.
Separate Phase II studies on lung and skin cancers, led by CRCHUM researchers in collaboration with Lawson and LHSCRI, demonstrated improved patient responses to immunotherapy after receiving FMT. In the lung cancer study, 80 percent of participants responded to immunotherapy following FMT, compared to typical response rates of 39-45 percent with immunotherapy alone. Similarly, among melanoma patients who received FMT, 75 percent experienced a positive response, compared to usual rates of 50-58 percent without FMT. Each clinical trial involved 20 patients.
Dr. Arielle Elkrief, co-principal investigator and Physician Scientist at CRCHUM, said: "Our clinical trial demonstrated that fecal microbiota transplantation could improve the efficacy of immunotherapy in patients with lung cancer and melanoma. The results also uncovered one possible mechanism of action of fecal transplantation-through the elimination of harmful bacteria following the transplant. Our results open up a novel avenue for personalized microbiome therapies, and fecal transplant is now being tested as part of the large pan-Canadian Canbiome2 randomized controlled trial."
Dr. Rahima Jamal, Director of the Unit for Innovative Therapies (UIT) at CRCHUM, added: "Fecal microbiota transplantation in melanoma and lung cancer opens an entirely new therapeutic avenue, made possible by the exceptional commitment of our patients and the teamwork. At the Unit for Innovative Therapies (UIT) of the CRCHUM, we have had the privilege of translating laboratory discoveries into early phase clinical trials and witnessing their concrete impact on people living with cancer."
The studies utilized advanced LND101 capsules produced by Lawson from healthy donor stools to restore gut microbiomes in patients undergoing treatment for different types of cancer.
Dr. Michael Silverman, Scientist at Lawson and Head of St. Joseph's Infectious Diseases Program said: "To use FMT to reduce drug toxicity and improve patients' quality of life while possibly enhancing their clinical response to cancer treatment is tremendous, and it had never been done in treating kidney cancer before this. And none of this would be possible if not for this close collaboration: innovating the FMT capsules in Lawson labs and introducing them at LHSCRI and CHUM to advance vital research initiatives. Also, because LND101 comes from healthy donors, production can be scaled up to eventually help large numbers of cancer patients."
Earlier research from London and CHUM indicated that FMT could safely augment treatment for melanoma; ongoing investigations are exploring its use in pancreatic cancer and triple-negative breast cancer as well as its established role against C. difficile infections.
Dr. Ricardo Fernandes, Scientist at LHSCRI and Medical Oncologist at LHSC stated: "Our hope is that our research will one day help people with cancer live longer while reducing the harmful side effects of treatment," adding that "We are world leaders in FMT research and we're excited about its potential."
Funding for these studies was provided by several organizations including Canadian Cancer Society; Ontario Institute of Cancer Research; Canadian Institutes of Health Research; AMOSO; Western University's Division of Medical Oncology; donors to London Health Sciences Foundation; St. Joseph's Health Care Foundation; Hesch Foundation; Weston Family Foundation.
