{"entity":{"id":"microbiome-modulation-io","kind":"technology","name":"Microbiome modulation to unlock immunotherapy","aka":[],"tldr":"Changing the gut bacteria of a patient whose immunotherapy stopped working, in the hope of restarting the response.","summary":"Gut composition predicts checkpoint-inhibitor response across cohorts, and small single-arm studies of faecal transplant from responders reported that a minority of refractory melanoma patients regained response. Randomised work is now running: LND101 with checkpoint blockade in advanced melanoma (NCT06623461, phase 2, Canadian Cancer Trials Group), an Oslo phase 2 using responder stool (NCT05286294), and a Netherlands Cancer Institute study (NCT05251389). Defined bacterial consortia are being developed as an alternative to whole stool.","status":"phase-2","asOf":"2026-09-08","links":[{"label":"LND101 + ICB phase 2 (NCT06623461)","url":"https://clinicaltrials.gov/study/NCT06623461"},{"label":"Oslo FMT phase 2 (NCT05286294)","url":"https://clinicaltrials.gov/study/NCT05286294"}],"tags":["frontier","promising"],"related":["frontier-2035"],"cancers":["melanoma","rcc"],"sections":["immunotherapy","supportive-care","nutrition-lifestyle"],"technologies":["checkpoint-inhibitor"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["cold-vs-hot"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Transferring or supplementing gut commensals alters antigen presentation, systemic interferon tone, and intratumoural T-cell infiltration, restoring sensitivity to PD-1 blockade.","strengths":["Cheap and repeatable","Targets the host, so it is tumour-genotype agnostic","Randomised trials now running"],"limitations":["Donor variability and transmission risk with whole stool","Effect sizes uncertain; no phase 3","Antibiotics and diet confound everything"]},"route":"/technologies/microbiome-modulation-io/","neighbours":{"roadmap":[{"id":"nutrition-lifestyle-roadmap","kind":"roadmap","name":"Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment","route":"/roadmaps/nutrition-lifestyle-roadmap/"},{"id":"frontier-2035","kind":"roadmap","name":"Radical oncology: what could change the war by 2035","route":"/roadmaps/frontier-2035/"}],"cancer":[{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"},{"id":"rcc","kind":"cancer","name":"Renal cell carcinoma","route":"/cancers/rcc/"}],"section":[{"id":"nutrition-lifestyle","kind":"section","name":"Diet, Exercise & Lifestyle","route":"/fronts/nutrition-lifestyle/"},{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"dietary-fibre-microbiome-io","kind":"technology","name":"Dietary fibre and the gut microbiome for immunotherapy response","route":"/technologies/dietary-fibre-microbiome-io/"},{"id":"fmt-checkpoint-nonresponders","kind":"technology","name":"Faecal microbiota transplantation for PD-1 non-responders","route":"/technologies/fmt-checkpoint-nonresponders/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"probiotics-antibiotic-stewardship-io","kind":"technology","name":"Probiotics, antibiotics and stewardship around immunotherapy","route":"/technologies/probiotics-antibiotic-stewardship-io/"}],"term":[{"id":"gut-microbiome-diversity","kind":"term","name":"Gut microbiome diversity and composition","route":"/terms/gut-microbiome-diversity/"},{"id":"cold-vs-hot","kind":"term","name":"Hot vs cold tumours","route":"/terms/cold-vs-hot/"},{"id":"immune-colitis","kind":"term","name":"Immune-mediated colitis and diarrhoea","route":"/terms/immune-colitis/"}],"trial":[{"id":"fmt-pd1-refractory-melanoma-pitt","kind":"trial","name":"FMT plus pembrolizumab in anti-PD-1-refractory melanoma (Pittsburgh)","route":"/trials/fmt-pd1-refractory-melanoma-pitt/"},{"id":"mimic-01","kind":"trial","name":"MIMic-01: healthy-donor FMT plus anti-PD-1, first-line melanoma","route":"/trials/mimic-01/"}],"institution":[{"id":"chum","kind":"institution","name":"Centre hospitalier de l'Université de Montréal (CHUM)","route":"/institutions/chum/"},{"id":"uchicago-cancer","kind":"institution","name":"University of Chicago Medicine Comprehensive Cancer Center","route":"/institutions/uchicago-cancer/"},{"id":"upmc-hillman","kind":"institution","name":"UPMC Hillman Cancer Center","route":"/institutions/upmc-hillman/"}]}}