A high-fiber diet may improve the response of melanoma patients to immunotherapy
A diet rich in fiber may help some people being treated for melanoma respond to immunotherapy treatment by influencing the gut microbiome, according to a new study led by researchers at the Center for Cancer Research at the National Cancer Institute (NCI), part of the National Institutes of Health, and the University of Texas MD Anderson Cancer Center. Results from the study, which analyzed both people with melanoma and mouse models of the disease, appear in Science.
Among patients with advanced melanoma who underwent immunotherapy with immune checkpoint blockers, those who consumed at least 20 grams a day of dietary fiber survived the longest without their disease progressing. In contrast, use of probiotic supplements appeared to lessen somewhat the effectiveness of immune checkpoint blocker regimens. Probiotics are live microorganisms typically consumed as a supplement to improve gut health.
“The data suggest that one can target the composition of the gut microbiota and affect the ability of the patient to respond to immunotherapy,” said Giorgio Trinchieri, M.D., chief of the Laboratory of Integrative Cancer Immunology in NCI’s Center for Cancer Research, one of the study’s coleaders. “Consuming a diet rich in fiber, like fruits, vegetables, and legumes, could improve your ability to respond to immunotherapy.”
Immunotherapy with immune checkpoint blockers helps restore the immune system’s natural ability to recognize and kill tumor cells. These drugs have been transformative in melanoma, improving how long some people with advanced disease live, sometimes by years. However, for many patients, immune checkpoint blockers fail to stop their tumors from growing. Several studies have suggested that the composition of the bacteria in the gut may influence the response to immunotherapy.
“The question is, can we change the composition of the type of bacteria in the gut and improve the ability of the patient to respond?” Dr. Trinchieri said.
In a previous study, Dr. Trinchieri and a different group of collaborators showed that some people with melanoma who initially did not respond to treatment with an immune checkpoint blocker did respond after receiving a fecal transplant from a patient who had responded to the drug. The fecal transplant, they concluded, had introduced different gut bacteria that helped make it easier for immune cells to invade and kill their tumors.
“Dietary fiber intake and use of probiotic supplements have also been shown to affect the composition of gut bacteria. More cancer patients are taking probiotic supplements in an effort to improve their gut health, but little is known about how probiotics—which basically change the ecology of the gut bacteria—impact immunotherapy response,” he said.
The connection between fiber intake and immunotherapy response has also been unclear. However, a recent study led by Romina Goldszmid, Ph.D., also of NCI’s Center for Cancer Research, showed that mice fed a diet rich in pectin, which is a fiber abundant in apples, were able to stave off tumor growth by activating immune cells and reprogramming the tumor microenvironment.
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Article Source: https://doi.org/10.1126/science.aaz7015
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