Use of Fecal Microbial Transplantation for Immune Checkpoint Inhibitor Colitis

Fasanello, Micaela K; Robillard, Kevin T.; Boland, Patrick M.; Bain, Andrew; Kanehira, Kazunori

doi:10.14309/crj.0000000000000360

Cited by 31 publications

(28 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Probiotic treatment has not been tested in humans in the context of IMC. Nevertheless, in two out of the three patients who received fecal microbiota transplantation (FMT), a quick reduction of inflammation, as observed by colonoscopy, was noticed (83,84). Following FMT, Bifidobacterium was elevated, even though the patients had a distinct taxonomy from each other prior to FMT (83).…”

Section: Bacterial Strainsmentioning

confidence: 99%

“…In addition to interfering with pathways of the immune system, targeting the microbiome is also an option for treatment of IMC. For instance, an experimental FMT immediately showed alleviation of IMC symptoms in patients refractory to corticosteroids, infliximab, and vedolizumab (83,84). FMT has already shown promising therapeutic effects in Clostridoides difficile infections (140).…”

Section: Mechanism-based Future Research and Approaches To Managementmentioning

confidence: 99%

See 1 more Smart Citation

Mechanisms of Immune Checkpoint Inhibitor-Mediated Colitis

et al. 2021

View full text Add to dashboard Cite

Immune checkpoint inhibitors (ICIs) have provided tremendous clinical benefit in several cancer types. However, systemic activation of the immune system also leads to several immune-related adverse events. Of these, ICI-mediated colitis (IMC) occurs frequently and is the one with the highest absolute fatality. To improve current treatment strategies, it is important to understand the cellular mechanisms that induce this form of colitis. In this review, we discuss important pathways that are altered in IMC in mouse models and in human colon biopsy samples. This reveals a complex interplay between several types of immune cells and the gut microbiome. In addition to a mechanistic understanding, patients at risk should be identifiable before ICI therapy. Here we propose to focus on T-cell subsets that interact with bacteria after inducing epithelial damage. Especially, intestinal resident immune cells are of interest. This may lead to a better understanding of IMC and provides opportunities for prevention and management.

show abstract

Section: Bacterial Strainsmentioning

confidence: 99%

Section: Mechanism-based Future Research and Approaches To Managementmentioning

confidence: 99%

Mechanisms of Immune Checkpoint Inhibitor-Mediated Colitis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Of note, FMT was associated with favourable changes in immune cell infiltrates and gene expression profiles in both the gut lamina propria and the tumour microenvironment. In addition, a small number of case reports of FMT successfully treating ICI-associated colitis have been published [103,104], representing an area of potential research interest.…”

Section: Can We Modulate the Gm?mentioning

confidence: 99%

The gut microbiome: what the oncologist ought to know

et al. 2021

View full text Add to dashboard Cite

The gut microbiome (GM) has been implicated in a vast number of human pathologies and has become a focus of oncology research over the past 5 years. The normal gut microbiota imparts specific function in host nutrient metabolism, xenobiotic and drug metabolism, maintenance of structural integrity of the gut mucosal barrier, immunomodulation and protection against pathogens. Strong evidence is emerging to support the effects of the GM on the development of some malignancies but also on responses to cancer therapies, most notably, immune checkpoint inhibition. Tools for manipulating the GM including dietary modification, probiotics and faecal microbiota transfer (FMT) are in development. Current understandings of the many complex interrelationships between the GM, cancer, the immune system, nutrition and medication are ultimately based on a combination of short‐term clinical trials and observational studies, paired with an ever-evolving understanding of cancer biology. The next generation of personalised cancer therapies focusses on molecular and phenotypic heterogeneity, tumour evolution and immune status; it is distinctly possible that the GM will become an increasingly central focus amongst them. The aim of this review is to provide clinicians with an overview of microbiome science and our current understanding of the role the GM plays in cancer.

show abstract

“…Both patients had complete recovery after treatment with the fecal transplant, although one of the patients needed two fecal transplants for complete resolution [ 99 ]. Fasanello et al presented another case report in which fecal transplantation was successful in healing colitis [ 102 ].…”

Section: Treatmentmentioning

confidence: 99%

Checkpoint Inhibitor-Induced Colitis—A Clinical Overview of Incidence, Prognostic Implications and Extension of Current Treatment Options

2021

View full text Add to dashboard Cite

In recent years, anti-tumor immunotherapies have witnessed a major breakthrough with the emergence of immune checkpoint inhibitors (ICIs). However, the use of ICIs has also brought an era of a certain class of adverse events that differ from those of classical chemotherapies and are more reminiscent of autoimmune diseases. This article focuses exclusively on colitis as an irAE with emphasis on vulnerable patient groups, the prognostic significance of colitis, treatment, and new therapeutic approaches that may be applicable. Colitis itself is associated with a favorable oncological outcome of the underlying disease but is as well the most common irAE leading to discontinuation of therapy. Especially in vulnerable patient groups such as IBD patients and elderly patients, colitis occurs more frequently as a side effect. It is precisely in these two patient groups that side effects more often lead to discontinuation of therapy. Therefore, in addition to the current therapy of colitis through immunosuppression, the focus should also be on new forms of therapy of severe colitis, such as fecal transplantation or ileostomy creation.

show abstract

Use of Fecal Microbial Transplantation for Immune Checkpoint Inhibitor Colitis

Cited by 31 publications

References 7 publications

Mechanisms of Immune Checkpoint Inhibitor-Mediated Colitis

Mechanisms of Immune Checkpoint Inhibitor-Mediated Colitis

The gut microbiome: what the oncologist ought to know

Checkpoint Inhibitor-Induced Colitis—A Clinical Overview of Incidence, Prognostic Implications and Extension of Current Treatment Options

Contact Info

Product

Resources

About