The long and winding road of fecal microbiota transplants to targeted intervention for improvement of immune checkpoint inhibition therapy

Expert Rev Anticancer Ther. 2023 Sep 25. doi: 10.1080/14737140.2023.2262765. Online ahead of print.ABSTRACTINTRODUCTION: Immune checkpoint inhibition (ICI) therapy has revolutionized the treatment of cancer. The principle of this treatment is that inhibitory molecules, either on the tumor or on cells of the immune system, are blocked by antibodies. The immune system of the patient subsequently should be able to attack and eradicate the tumor. Not all patients respond to ICI therapy, and response or non-response has been associated with composition of gut microbiota.AREA COVERED: Fecal microbiota transplantation (FMT) is used as adjunctive therapy in order to improve the outcome of ICI. Clinical Trials.gov, Clinical Trials in the European Union, Australian New Zealand Clinical Trials Registry, and the International Clinical Trials Registry Platform of the World Health Organization were searched (October 2022) for studies dealing with gut microbiota modification and the outcome of ICI.EXPERT OPINION: There is ample evidence for the beneficial effect of FMT on the outcome of ICI therapy for cancer, especially melanoma. The optimal treatment schedule, as well as donor selection criteria, still must be worked out. Progress is being made in the unraveling of the mechanisms by which microbiota and their metabolites (butyrate and the tryptophan metabolite indole-3-aldehyde) interact with the mucosal immune system of the host. A better understanding of these mechanisms contributes to ...
Source: Expert Review of Anticancer Therapy - Category: Cancer & Oncology Authors: Source Type: research