Loading
Patients who eat plenty of fibre and avoid probiotic pills seem to respond better to immunotherapy for melanoma, probably because fibre feeds the right gut bacteria. A proper trial is under way.
In 128 melanoma patients on checkpoint inhibitors (Spencer et al., Science 2021), each 5 g/day of dietary fibre was associated with a 30% lower risk of progression or death, and the combination of sufficient fibre (at least 20 g/day) with no probiotic use had the best outcomes; in mice, low fibre or probiotics impaired the anti-PD-1 response. Gut taxa such as Faecalibacterium, Ruminococcaceae and Akkermansia repeatedly associate with response across cohorts, though the specific species differ by study and geography. This is observational in humans and confounded by overall health, so a fibre-intervention trial is the right next step; a randomised high-fibre diet trial in melanoma patients starting immunotherapy is recruiting at MD Anderson. The pragmatic message that is defensible today: eat more fibre, do not take over-the-counter probiotics, and avoid unnecessary antibiotics around immunotherapy.
Fermentable fibre yields short-chain fatty acids and sustains bacterial taxa that enhance dendritic-cell antigen presentation and systemic interferon tone, increasing CD8 T-cell infiltration into tumours.
Query for this technology: (TITLE:"Dietary fibre and the gut microbiome for immunotherapy response" OR ABSTRACT:"Dietary fibre and the gut microbiome for immunotherapy response") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Dietary fibre and the gut microbiome for immunotherapy response, not a curated reading list.
Shares Gut microbiome diversity and composition, Microbiome modulation to unlock immunotherapy, Faecal microbiota transplantation for PD-1 non-responders, Microbiome-tumour interactions.
Shares Laurence Zitvogel, Capture diet, fibre and antibiotic exposure in every immunotherapy pivotal trial, Probiotics, antibiotics and stewardship around immunotherapy, No one can predict who responds to immunotherapy.
Shares Gut microbiome diversity and composition, Microbiome modulation to unlock immunotherapy, Faecal microbiota transplantation for PD-1 non-responders, Microbiome-tumour interactions.
Shares Laurence Zitvogel, Faecal microbiota transplantation for PD-1 non-responders, No one can predict who responds to immunotherapy, Renal cell carcinoma.
Shares Hallmark (2022): polymorphic microbiomes, Faecal microbiota transplantation for PD-1 non-responders, Microbiome-tumour interactions, MD Anderson Cancer Center.
Shares MD Anderson Cancer Center, No one can predict who responds to immunotherapy, Melanoma, Pembrolizumab.
Shares Ipilimumab, Renal cell carcinoma, Nivolumab, Melanoma.
Shares MD Anderson Cancer Center, Ipilimumab, Nivolumab, Melanoma.