True therapeutic revolution, immunotherapy has proven to be superior to standard therapy in the management of some cancers such as metastatic melanoma, lung cancer, kidney or even the bladder.
New immunotherapies, by transfer of activated T lymphocytes or by monoclonal antibodies, trigger the awakening of the patient’s immune system. They thus make it possible to reduce the size of tumors but also, and for the first time, to significantly prolong the survival of patients or even cure them of metastatic or locally advanced cancers.
The key role of the gut microbiota
Unfortunately, the effectiveness of immunotherapy has so far remained limited to a proportion of patients, some patients not responding at all to treatment.
A study by researchers from Gustave Roussy, Inserm and INRA, published in the journal Science, undoubtedly provides an answer. When patients take antibiotic antibiotics because of a dental, urinary or lung infection, it changes their gut microbiota, which would negatively impact cancer treatment.
The results of this study show that by creating an imbalance in the intestinal microbiota(or dysbiosis), taking antibiotics two months before and up to one month after starting treatment has a negative impact on disease progression-free survival and the overall survival of patients in three types of cancer: cancer advanced lung, kidney and bladder.
A bacterium helps restore the effectiveness of immunotherapy
To prove a direct cause and effect link between the composition of the gut microbiota and the efficacy of immunotherapy, a favorable microbiota (from patients who have demonstrated a good clinical response to immunotherapy) and an unfavorable microbiota (from patients failed) were transferred to mice that lacked it.
The mice transplanted with the favorable microbiota showed a favorable course of treatment when they were treated with immunotherapy, unlike those with the unfavorable microbiota. But in the latter, the administration of a bacterium (Akkermansia muciniphila) made it possible to restore the effectiveness of immunotherapy.
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