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Hi! Angus Chen, STAT's cancer reporter, here. There was a trio of Nature Medicine studies this week showing that fecal transplants might be able to improve responses to immunotherapy in patients with renal cancer, lung cancer, or melanoma. One of these trials was a randomized Phase 2 trial where patients getting anti-PD1 treatment and axitinib, a targeted therapy for renal cancer, either got a donor FMT or a placebo FMT. Those who got the real FMT had a significant benefit, with a median PFS of 24 months compared to 9 months on the placebo arm. There's been a lot of evidence over the years that having a healthy gut helps cancer immunotherapy, and these studies add to the very real and exciting possibility that oncologists could use fecal transplants to boost responses. How we would get there may be tricky though, as Sumanta Pal, a cancer research and medical oncologist at City of Hope, told me. For one, it's not entirely clear yet what exactly the good poop is that leads to good responses. In this one Phase 2 trial, the FMT all came from a single donor — not exactly a scalable solution. While there are groups investigating what specific assemblage of microbiota may make up an effective fecal transplant, or finding other ways to build FMT at scale. "It underscores one of the fundamental issues, which is how can that span out into something that translates into broader clinical practice," Pal said. |
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