2024 World Conference on Lung Cancer (WCLC) - Posters-P2.11A.23 Fecal Microbiota Transplantation Plus Rechallenging Immunotherapy in Patients with Advanced Non Small Cell Lung Cancer: An Exploratory Study

P2.11A.23 Fecal Microbiota Transplantation Plus Rechallenging Immunotherapy in Patients with Advanced Non Small Cell Lung Cancer: An Exploratory Study

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The exploratory study investigated the effects of combining Fecal Microbiota Transplantation (FMT) with rechallenging immunotherapy in patients with advanced Non-Small Cell Lung Cancer (NSCLC) who developed progression following initial immunotherapy. Conducted as a single-center, single-arm, prospective study, seven patients were included, receiving FMT orally via capsules, alongside immunotherapy using Camrelizumab.<br /><br />Safety evaluation showed that adverse events were predominantly mild to moderate (Grade 1 and 2), with only 7.6% being Grade 3, and no higher-grade adverse events occurred. The adverse events associated with FMT were mild, including symptoms like nausea and diarrhea. The objective response rate (ORR) to the combined treatment was 14.3%, and the disease control rate (DCR) was 28.6%. Response analysis showed that two patients experienced prolonged progression-free survival (PFS) and overall survival (OS).<br /><br />Microbiota analysis revealed significant changes, notably increased prevalence of particular bacterial species such as Prevotella_9 and emergence of Megamonas, indicating alteration in gut bacteria due to FMT. Patients in the responder group exhibited higher levels of certain bacterial species compared to non-responders. Host metabolism analysis identified 114 metabolites differing between pre- and post-treatment, with sulfur metabolism being notably altered. TCR analysis showed significant changes in TCR gene fragments post-treatment, indicating immune system modulation.<br /><br />Conclusively, the study suggests that combining FMT with immunotherapy is generally safe and may positively impact gut microbiota and immune response markers, potentially overcoming immunotherapy resistance. However, it acknowledges the necessity for larger-scale studies to validate these preliminary findings.

Asset Subtitle

Mei Juan Huang

Meta Tag

Speaker Mei Juan Huang

Topic Metastatic NSCLC – Immunotherapy

Keywords

Fecal Microbiota Transplantation

immunotherapy

Non-Small Cell Lung Cancer

Camrelizumab

gut microbiota

immune response

microbiota analysis

progression-free survival

disease control rate

safety evaluation