What's in Your Gut? It May Keep You Alive!

I don't know about you, but I try to keep up with what's going on in the research world. The problem is that I don't always understand a lot of scientific "mumbo-jumbo" (only to me ... it makes great sense to those who are much smarter than I am). My preference is to attend conferences or summits where doctors/researchers come to speak to us and tell us what is going on in the field using lay person's language. Unfortunately, it isn't often possible to attend such meetings.

Wading Through the Latest Research

So, I at least try to read headlines of studies from reliable sources ... and may click on them to see if the study results have been written in such a way that I can understand at least some of what was written. I just clicked on such a headline and it has me excited!

The National Institutes of Health (NIH) recently published a "Cancer Commons" blog entitled "Gut Bacteria Influence Effectiveness of a Type of Immunotherapy." Since immunotherapy has been keeping me alive for the past 4.5 years, I nearly always click on studies about that topic.

Understanding Beneficial Bacteria

So, here's the gist of what several recent studies conducted all over the world have found: what's in your gut can mean the difference between whether checkpoint inhibitor immunotherapy works for you or doesn't. If your stomach has lots of "good bacteria" in it, the checkpoint inhibitors are more likely to work for you.

This is important in two ways:

1. Doctors were able to collect and use stool samples to determine how much good bacteria exist in a patient's belly. By identifying "good" bacteria, scientists correctly predicted which patients would respond to immunotherapy. This could save valuable treatment time by not subjecting it on those for whom the immunotherapy is unlikely to work. (My oncologist says that one of the worst side effects of immunotherapy is disappointment. Everyone has such high hopes for it since it works so well in those who respond to it.)
2. Researchers are working to find ways to change the ratio of good and bad bacteria in your stomach. So, even if you do not currently have the good bacteria needed, it may be possible to change that. Clinical trials will begin in the not so distant future to try doing exactly that.

An Interesting Research Connection for Future Study

The article quotes Dr. Douglas Johnson, an oncologist at Vanderbilt University who is not part of these studies as saying, "But a clinical trial looking at [changing the microbiome] would be low risk for patients, and may give us some more insight into what may or may not work."¹

I got excited. I would be so interested in participating in a study like that!!! I probably wouldn't be a candidate, unless as a control group patient, because, based on my response to Opdivo, I suspect that I already have lots of good bacteria in my stomach.

The NIH blog said that a culprit for reducing the number of good bacteria in our bellies (aka gut microbiome) is antibiotics. One study showed that patients who took antibiotics within two months before or one month after beginning immunotherapy did not respond as well to immunotherapy treatments as their colleagues who took no antibiotics.

Scientists have not yet identified exactly what microbiome works best. The various studies found different good bacteria that predicted the success of checkpoint inhibitor immunotherapy. You can bet a lot of effort will be devoted in upcoming days to pinpointing the microbiomes that are most likely to result in patients having a positive response to treatment.