Experts have long known that the “microbiome” – the three-pound symbiotic collection of fungi, bacteria and viruses inhabiting every human’s gut – plays an integral part of our health. But only recently have we discovered the specifics of why the microbiome is so important, especially as it relates to cancer.

Thanks to recent advances in research areas such as high-throughput sequencing, microbiologic and metabolic data we know today that the microbiome functions essentially as an internal metabolic organ. And this “organ,” they’ve found, may play a role in metabolizing medications used to treat cancer, helping or hindering them to varying degrees.

“We’re now at the point where we can begin to talk about [the microbiome and] intervention, whether that might be with diet, drug or molecule,” said Lynn Bry, MD, who is an associate pathologist at Brigham and Women’s and the Director of the Massachusetts Host-Microbiome Center. Bry is also an associate professor of pathology at Harvard Medical School.

We’re now at the point where we can begin to talk about [the microbiome and] intervention, whether that might be with diet, drug or molecule.

It is because of this potential that the “Microbiome and Cancer” was one of this year’s Disruptive Dozen cancer innovations at the World Medical Innovation Forum. As an expert in the field, Bry was selected to present on the role the microbiome could play within cancer research over the next ten years.

“There are a few key areas where I look to see the role of microbiota in cancer treatment,” Bry said. “There’s the effect of directly promoting cancer growth, such as when our microbes metabolize processed meats and create carcinogens. We also know they metabolize a number of cancer drugs, which can further damage the gut and cause side effects.”

Understanding these cause and effect interactions is integral to the future of cancer treatment. It’s also a third area where Bry and other researchers at Newton-Wellesley Hospital and Brigham & Women’s Faulkner are seeing fascinating results and synergy with other cancer fields, such as immunotherapy, specifically immune checkpoint inhibitors.

Immune checkpoint inhibitors are a fledgling-but-promising category of drugs that allow the immune system to attack cancer cells. Several drugs are already on the market to treat advanced stage melanomas and lung cancers; the process of combining these therapies with gut bacteria is still in its infancy.

According to Bry, there are a number of studies that show colonizing checkpoint inhibitors with certain microbes can make the drugs more effective at treating certain types of cancer, such as melanoma. Case in point: early research has shown that when a strain of bacteria was combined with the investigational anti-cancer antibody anti-PD-L1, and then introduced into the digestive tracts of mice with melanoma, the tumors nearly disappeared.

Bry cautions we’re in the early days, but there is undoubtedly potential. “There’s more to learn, but we’ve got interest now thanks to the positive discoveries related to what microbes do to prevent and promote cancer, and create successful treatment.”

This post is one of several that will appear in Connect with Partners on the Disruptive Dozen announced at the Partners World Medical Innovation Forum. Read our first post on Nanotechnology and Cancer to see how technology is disrupting treatment today.

Topics: Clinical Trials, Innovation, Scholarship

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