Take faecal transplant plus immunotherapy to a definitive trial
Transferring gut bacteria from patients who responded to immunotherapy has helped some patients who had stopped responding. It is time for a proper large trial.
Two independent phase 1 studies reported that faecal microbiota transplant from checkpoint responders re-sensitised some anti-PD-1-refractory melanoma patients, and a first-line study of donor transplant with checkpoint blockade showed feasibility and encouraging response. The field has stayed in small single-arm studies for years. A randomised trial with a defined donor consortium, standardised product and pre-specified microbiome endpoints would settle whether the effect is real.
- No one can predict who responds to immunotherapy · Checkpoint drugs cure some patients and do nothing for most. We still cannot tell the two apart before treating.
- Cold tumours and the immunosuppressive microenvironment · Most tumours keep the immune system out or asleep, so immunotherapy helps only a minority.
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- TermGut microbiome diversity and composition
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