Oncology and immunotherapy
The gut microbiome influences the efficacy of anti-tumor immunotherapy. FMT is being investigated as a method for restoring the microbiota after chemotherapy and enhancing the response to checkpoint inhibitors.
Experimental field: FMT is not a cancer treatment. It is an investigational complementary method aimed at supporting standard oncotherapy. Only by oncologist decision.
FMT in oncology: two directions
Research on FMT in oncology is developing in two main directions.
Recovery after chemotherapy
Chemotherapy causes significant damage to the gut microbiome, destroying not only cancer cells but also beneficial bacteria. This leads to severe side effects.
- Severe diarrhea and mucositis
- Increased risk of infections
- C. difficile infection
- Prolonged microbiome recovery
FMT may help
Restoring a healthy microbiome after a course of chemotherapy may accelerate GI recovery, reduce infection risk, and improve tolerance of subsequent treatment cycles.
Enhancing immunotherapy
Checkpoint inhibitors (PD-1, CTLA-4) have revolutionized oncology. But not all patients respond to therapy. Microbiome composition may determine the response.
- Microbiome composition influences response to immunotherapy
- Certain bacteria are associated with better prognosis
- FMT from responders may "transfer" the response to therapy
- Akkermansia, Faecalibacterium — key species
Important notes
FMT in oncology is an experimental field. Safety in immunocompromised patients requires special caution. Only within clinical trials or by individual oncologist decision.
How does the microbiome influence immunotherapy?
Scientific discoveries in recent years have revealed the critical role of the microbiome in the anti-tumor immune response.
Dysbiosis
Unfavorable microbiome composition
Weak immune response
The tumor "escapes" the immune system
FMT from a responder
"Transfer" of a favorable microbiome
Enhanced response
Activation of anti-tumor immunity
Mechanism of action
Certain bacteria (Akkermansia, Bifidobacterium, Faecalibacterium) stimulate dendritic cells and T lymphocytes, enhancing the immune system's ability to recognize and destroy tumor cells.
Potential applications
- Melanoma (most studied)
- Lung cancer
- Kidney cancer
- Hematological malignancies
Disclaimer: FMT in oncology is performed only within clinical trials or by individual oncologist decision. Self-treatment is unacceptable.
Research results
Breakthrough studies demonstrate the link between the microbiome and immunotherapy efficacy and the potential of FMT.
65%
Response to immunotherapy after FMT (Davar et al.)
20+
Clinical trials worldwide
Science
Publications in leading journals
Akkermansia
Key bacterium for immunotherapy response
Key studies
- Routy et al., Science 2018: Microbiome composition predicts response to anti-PD-1 therapy. Akkermansia muciniphila is a key species for immunotherapy success
- Davar et al., Science 2021: FMT from responders overcame immunotherapy resistance in melanoma patients — response rate increased from 30% to 65%
- Baruch et al., Science 2021: Confirmation: FMT can "transfer" immunotherapy response from donor to recipient in refractory melanoma
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Researcher's perspective
Expert opinion on the role of FMT in oncology
"We are on the verge of a revolution in understanding how the microbiome influences anti-tumor immunity. The results of the first clinical trials of FMT in melanoma are striking — we see patients who did not respond to immunotherapy beginning to respond after microbiota transplantation."
Researcher in onco-microbiomics
Based on scientific publications in Science 2021
Related directions
FMT is also being studied for other conditions related to immunity
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Undergoing cancer treatment?
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