London researchers trying poop to treat deadly skin cancer

It may sound like a smelly course of action, but a London research institute is experimenting to see if human feces can be used to treat melanoma patients.

A team at the Lawson Health Research Institute will soon be conducting clinical trials that will have participants receive a “fecal transplant” from a healthy donor.  The stool sample will be prepared in a lab before being transplanted through an oral capsule, with the goal of having healthy bacteria colonize in the patient’s gut.

“The gut microbiome helps establish immunity from an early age. It makes sense that a healthy gut could improve response to immunotherapy,” said Dr. Jeremy Burton, a Lawson scientist who specializes in human microbiome research. “This led us to consider the potential of fecal transplants.”

Researchers will be recruiting 20 melanoma patients, who are undergoing immunotherapy treatment, from the London Regional Cancer Program at the London Health Sciences Centre (LHSC).  Patients will be assessed over time for any changes to their cancer, microbiome, immune system and overall health.

Immunotherapy drugs stimulate a person’s immune system to attack and destroy cancer. While they can significantly improve survival outcomes in those with melanoma, they are only effective in 40-50 per cent of patients.

“Melanoma is the least common skin cancer but it is the most deadly and rates are going up,” said Dr. John Lenehan, an associate scientist at Lawson and Oncologist at LHSC. “Anti-PD1 immunotherapy drugs can be extremely effective but we want to help more patients respond. That’s our goal.”

The research team is the first in Canada to study the use of fecal transplants to alter a cancer patient’s microbiome and improve their response to immunotherapy drugs. However, fecal transplants have been used in the past to treat patients across Ontario with Clostridium difficile infections.

“Fecal transplants have saved the lives of countless patients with recurrent C. diff,” said Dr. Michael Silverman, a Lawson associate scientist and chief of infectious diseases at St. Joseph’s Hospital and LHSC. “We’re now starting to see its potential for the treatment of other diseases.”