Immunotherapy: of the extreme importance of the microbiota

These bacteria that colonize our digestive tract may reduce the effectiveness of treatment in patients with cancer.

The right balance of the microbiota – those billions of commensal bacteria that live in our digestive tract – plays a key role in the efficiency of our immune system. It is therefore not surprising that it also has great importance in immunotherapy. “In metastatic melanoma, two recent studies have shown that half of patients resistant to treatment by anti-PD1 immunotherapy could be resensitized and saved, by transferring the faecal flora of patients who respond well to the same treatment to them. The result seems to depend more on the donor than on the recipient ”, explains the Pr Laurence Zitvogel, immuno-oncologist (Institut Gustave-Roussy, Villejuif).

Risk of non-response

His team had shown in 2017 that antibiotics are immunosuppressive and increase the risk of non-response to immunotherapy. “This has since been confirmed by dozens of studies. We now know that we must wait at least a month between treatment with antibiotics and the start of immunotherapy

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