SITC 2022 | Microbiome modification with fecal transplant before IO to reduce primary resistance in melanoma

Saman Maleki, PhD, Western University, London, Canada, provides an overview of an investigation into microbiome modification with fecal microbiota transplant from healthy donors before anti-PD1 therapy to reduce primary resistance to immunotherapy in patients with advanced and metastatic melanoma. Patients firstly underwent bowel prep to get rid of their own microbiome prior to the fecal microbiota transplant. After 7 days, patients began treatment with anti-PD1 therapy with either nivolumab or pembrolizumab to evaluate safety of the approach. There were no unexpected toxicities observed. Translational analysis of the patient samples revealed the microbiome of the healthy donors were much more diverse compared to the patients with melanoma. The diversity of the patient’s microbiome increased following the fecal transplant, however, this increase was not associated with response. Being able to retain the microbiome, on the other hand, was essential for patients’ response to immunotherapy, validating the significance of the microbiome for anti-tumor immunity. The presence of certain metabolites in the patient’s plasma was also correlated with response to therapy. This interview took place at the 37th Annual Meeting of the Society for Immunotherapy in Cancer (SITC 2022) in Boston, MA.

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