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Patients with bowel cancer will receive a breakthrough treatment aimed at altering the composition of their intestinal bacteria, as part of a trial to be launched this year.
The Phase 1 trial, supported by a £ 20 million grant from Cancer Research UK, is led by an international team that is investigating whether intestinal bacteria play a role in triggering cancer and making the disease more resistant to treatment in some patients.
Professor Wendy Garrett, of the Harvard TH Chan School of Public Health and co-lead of the project, said that in the future, treatments intended to reset the microbiome or modify it slightly could be used alongside conventional anticancer drugs.
"Everyone involved in this project wants to improve outcomes for patients with bowel cancer and we want to finally prevent it," she said.
The human intestine contains billions of bacteria, which play a crucial role in the digestion of food and strengthening of the immune system. But it is becoming increasingly clear that some strains of bacteria may be involved in cancer initiation, uncontrolled development, or cancer resistance to chemotherapy and other treatments.
The initial trial, which should involve a dozen patients, will investigate the possibility of using stool transplants to restore the intestines of patients by reducing the presence of cancer-badociated microbes.
The procedure involves transplanting a stool sample, as well as the microbes it contains, from a healthy donor. The test will focus on safety and side effects.
Previous work by Garrett and the other co-leader of the project, Professor Matthew Meyerson, also from Harvard, revealed that intestinal bacteria looked different in patients with bowel cancer. A study revealed that a microbe called Fusobacterium nucleatum was more common in cancerous tissues and cancer patients than in healthy people.
When mice predisposed to developing cancer were exposed to this bacteria, the tumors appeared faster. "Maybe this bacterium plays a role in the development of bowel cancer or slows the development of bowel cancer," Garrett said.
One theory in the study is that the bacteria stick to precancerous cells and protect them from the immune system. This could potentially leave them spiraling into a cancerous condition and forming a tumor.
Studies have also shown that some good bacteria are more common in patients who respond to both chemotherapy and new cancer treatments with immunotherapy.
Bowel cancer is the fourth most common cancer in the UK and accounts for 12% of all new cancer cases in 2015. Various lifestyle factors have been shown to influence the risk of developing the disease. including diet and obesity.
Meyerson said the project, which involves collaborators in Canada, the UK, Spain and the Netherlands, would look at whether changes in intestinal bacteria are related to these lifestyle factors. The team will also try to determine if the "bad" bacteria are causing intestinal cancer or if they are simply growing in a cancerous environment.
"Maybe this will be extremely important for the understanding, treatment and prevention of bowel cancer," said Meyerson. "Maybe it will just be a phenomenon that is there. As long as we have not answered many questions, we will not know. "
The project will examine other potential future treatments, including antibiotics and vaccines that may trigger an immune response against targeted microbial communities in the intestine.
According to Meyerson, screening is currently the best known way to improve outcomes in patients with bowel cancer because the treatment is most effective in the early stages of the disease. "There is a lesson that the average citizen needs to know about bowel cancer, that's probably all," he said.
The project is being funded under the Cancer Research UK Grand Challenge initiative, which will see the charity making major grants to US institutions for the first time.
Michelle Mitchell, director of the charity, said, "To reach our goal of surviving three out of four people with cancer by 2034, we need to collaborate not only with researchers around the world, but also with donors. funds that share our goals. "
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