Background
The utilization of FMT can influence how metastatic melanoma patients respond to anti-PD-1 immunotherapy.
Numerous microbes inhabit the human gut. The colon itself has approximately 1000 different species of known bacteria. However, the bacterial population differs greatly between individuals due to factors such as genetics and lifestyle. The intestinal microbes play an important role in health and disease and a state of the delicate balance of the microbial is important for maintaining health. Sometimes, the balance can be disrupted by factors such as genetics, diet, antibiotics, or stress. Mounting evidence has suggested that the gut microbiota are related to a variety of cancers, which may enlighten potential development of cancer therapies targeted at the gut microbiome
Interventions to deal with disorders associated with disruptions in the intestinal microbiota homeostasis target the diet, probiotics, prebiotics, antibiotics, and fecal microbiota transplantation (FMT).
FMT
FMT involves the transplantation of gut microbiota from healthy donors to sick patients. The stool is taken from a healthy donor and is made into a liquid mixture that is transferred into the colon of a sick person via the upper or lower gastrointestinal route. The aim is to restore or boost helpful organisms or increase the diversity of intestinal microbes. It is the most innovative method since it has the ability to alter the microbiota in the recipients’ gut. FMT mainly treats recurrent Clostridium difficile (C.diff) infection that becomes difficult to treat even after adequate antibiotic treatment
FMT immunotherapy-refractory melanoma patients
The utilization of FMT can influence how metastatic melanoma patients respond to anti-PD-1 immunotherapy.
Any healthy individual can be a fecal donor, close relatives, family members, or unrelated individuals, however, healthy unrelated individuals from a centralized stool bank are the best donors. The donors are first screened in preparation for FMT according to protocol. The fecal material is then frozen for convenient management although the bacterial diversity of the frozen material is lower than that of a fresh one. It can be administered as a capsule, via nasogastric or nasoduodenal tube, enema, or colonoscopy
Conclusion
FMT is an effective and acceptable treatment of recurrent C.diff infection. It restores microbial diversity and bacterial metabolites, moreover, regulates bile acid metabolism. The relationship between intestinal microbiota and cancer provides an opportunity for exploring new diagnostic and therapeutic applications for cancer. FMT changes the gut microbiota composition alleviating cancer and enhances the efficacy of cancer immunotherapy providing positive clinical outcomes. There are notable favorable changes in immune cell infiltrates and gene expression profiles in the gut as well as the tumor microenvironment after treatment with FMT.
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References
https://gastro.org/practice-guidance/gi-patient-center/topic/fecal-microbiota-transplantation-fmt/
https://science.sciencemag.org/content/371/6529/602
https://pubmed.ncbi.nlm.nih.gov/30458058/
