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Medical tests have shown that a bacterium causing gangrene, which can be harmful in high doses, could help treat patients with advanced cancer in case of failure of other options.
Safety tests on a new type of "bacterial treatment" revealed that tumors that became resistant to other treatments became necrotic and decreased when injected with bacterial spores.
Doctors at the University of Texas used a bacterial strain related to bacterial infection in the lethal hospital superbug Clostridium difficile, which has been modified to make it less harmful to humans.
Clostridium novyi-NT needs an environment containing very little oxygen to survive. it means that it will not grow in healthy tissue with a good blood supply, but that dense, fast-growing tumors are a perfect host.
"By exploiting the inherent differences between healthy and cancerous tissues, Clostridium novyi-NT represents a very precise cancer treatment that can specifically attack a patient's cancer," said Dr. Filip Janku of the University's Anderson Cancer Center. .
The bacteria could be particularly powerful in combination with a new generation of cancer treatments called immunotherapies, which stimulate the immune system to identify and attack tumors, he added.
The results are presented Sunday at the International Conference on Cancer Immunotherapy in New York and, although they have not yet been published in a scientific journal, they have already sparked new trials.
Potential new medical treatments require several rounds of human testing, first to verify their safety, then to prove that they routinely improve survival within large patient populations.
During the trials, Dr. Janku and his colleagues focused on what doses could be used safely.
They recruited 24 patients with solid tumors who became resistant to conventional chemotherapy and other treatments, and injected between 10,000 and three million bacterial spores.
The authors report that the two patients receiving the highest dose developed severe sepsis and "gas gangrene". As a result, the team identified a safe dose of one million spores in which the side effects were "manageable".
In the remaining 22 patients, the first results showed that the treatment had stopped growing and that in 23% of the cases, the size of the tumors had decreased by more than 10%.
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However, the final reduction of the tumor could be even greater, said Dr. Janku, because the treatment initially causes inflammation and swells the tumor with the immune cells that attack it.
This method of treatment has two advantages: in 46% of cases, the bacterial spores germinated and began to multiply, rapidly causing necrosis and cell death in the tumor; However, even when the spores have not developed, due to lack of oxygen or other conditions, the presence of these bacterial spores has helped the immune system to wake up and attack the tumor.
"From these preliminary results, it appears that Clostridium novyi-NT is able to activate the immune response in addition to causing tumor destruction," added Dr. Janku.
"We were extremely encouraged by the results of this trial, especially in patients with advanced sarcomas, where immunotherapy has not been proven effective.
"This bacteriolytic strategy could be clinically significant, particularly in combination with checkpoint inhibitors, for patients with advanced solid tumors."
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