Fecal microbiome transplantation shows promise in treating colitis

Immunotherapy, the Nobel Prize-winning category of cancer therapy that helps your immune cells to fight tumors, has transformed the field of cancer care by improving the long-term survival in patients with various types of cancer, like melanoma and those affecting the organs in the genital and urinary systems.

One type of immunotherapy called immune checkpoint inhibitors (ICI), releases a brake on the immune system and activates a type of white blood cell to attack cancer cells. But these treatments can cause severe, sometimes life-threatening side effects.

My research team at MD Anderson in Houston, Texas, and I just published a study that shows promise in treating these side effects, and more importantly, possibly in allowing these patients to continue cancer treatment.

Cancer and colitis

One common and serious side effect of ICI treatment is inflammation of the colon, or colitis. It can occur in up to 40 percent of patients. Symptoms include diarrhea, rectal bleeding, abdominal pain, and/or fever. These can cause severe dehydration that may need fluid replacement and blood transfusion, which require hospitalization. When ICI-associated colitis is severe, treatment guidelines recommend that patients stop ICI therapy until the colitis resolves.

This is unfortunate because colitis development indicates that the cancer is responding well to ICI therapy. By stopping ICI, we are taking away an effective treatment. Therefore, we need to find remedies for ICI-associated colitis to quickly cure the condition and get our patients back on their cancer therapy.

Fecal transplant therapy: taking healthy stool from a donor, and processing and delivering it to a sick recipient. VectorMine/Shutterstock.com
Currently, doctors treat these patients with steroids and other agents that suppress the immune function. But these can trigger their own adverse effects and potentially counteract the immunotherapy and drive cancer growth and spread. In addition, some patients develop colitis that fails to respond to all of these treatments.