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Fecal transplants may help flush tumors from body, Israeli doctors find

Three melanoma patients with weeks to live responded to treatment after taking capsules of poop that transformed gut microbiome, Sheba-based team reports in peer-reviewed research

Nathan Jeffay is The Times of Israel's health and science correspondent

In this June 19, 2014, photo, technical assistant Eliska Didyk, wearing protective gloves, displays a bottle containing human fecal matter solution, frozen to minus 80 degrees Celsius, in an OpenBiome laboratory, in Medford, Massachusetts. (AP/Steven Senne)
In this June 19, 2014, photo, technical assistant Eliska Didyk, wearing protective gloves, displays a bottle containing human fecal matter solution, frozen to minus 80 degrees Celsius, in an OpenBiome laboratory, in Medford, Massachusetts. (AP/Steven Senne)

Three terminal cancer patients treated with pills of fecal matter saw their tumors shrink, and in one case disappear completely, Israeli doctors say,

The results of the small Phase I study of fecal microbiota transplantation at Sheba Medical Center were published this month in the peer-reviewed journal Science, sparking hopes of a possible new lifeline for cancer patients.

“For the first time in the world, we have successfully fought tumors by modulating the gut microbiome,” Dr. Ben Boursi, oncologist at Sheba’s Gastrointestinal Cancer Department, told The Times of Israel.

The three patients were part of a 10-person cohort of melanoma patients treated with the pills three years ago, after doctors said they had no established treatment options remaining and had just weeks to live.

They had previously been failed by immunotherapy, but when they restarted treatment while taking pills, the three showed improvement based on imaging, gene profiles and examinations.

Sheba Medical Center oncologist Dr. Ben Boursi (courtesy of Sheba Medical Center)

Two of them surprised doctors by living for a year, and one of them is still alive, leading a normal life without signs of cancer. The other seven saw little or no benefit from the pills.

While icky-sounding, the use of fecal matter as a treatment for various ailments dates back to the late 1950s. The treatment works by transplanting gut microbes of healthy donors to patients, thereby changing the composition of the gut microbiome, and was used to treat various gastrointestinal disorders.

In recent years, researchers have increasingly begun to study possible therapeutic effects of the treatment for other ailments as well. (It has also been explored as a possible weight control tool.)

Three years ago, Boursi, together with Prof. Gal Markel and other colleagues, decided to create the pills and initiate the Phase I clinical trial, prompted by oncologists’ fascination with the gut environment. They increasingly believe that differences in the so-called gut microbiome of patients may help to determine why some respond to immunotherapy while others don’t.

“We were keen to try this method to modulate the gut microbiome because immunotherapy only works for 40 percent to 50% of patients,” Boursi said. “We want to turn as many of the others as possible from non-responders to responders.”

Feces capsuled developed by Sheba Medical Center doctors for melanoma patients (courtesy of Sheba Medical Center)

The study was the first time fecal microbiota transplantation was deployed to combat cancer. The pills were made by extracting small amounts of matter from the feces of melanoma patients who were thought to be cured and showed no evidence of the disease in imaging, Boursi said.

Bolstered by the results, Boursi’s team now hopes to test the pills, which are odorless and tasteless, on other malignancies that are treated with immunotherapy.

“These pills could help patients with melanoma and various other cancers treated with immunotherapy, including colon, lung and bladder,” he said. “What we have shown so far is this is feasible, safe and relatively inexpensive and what we want to do now is to run additional clinical trials and lab studies.”

“We’re now expanding to involve more melanoma patients, as well as a type of lung cancer, and the plan is to continue clinical trials.”

Nissan Yissachar, a cancer expert from Bar-Ilan University who is unconnected to the new Sheba study, described it as “serious science by serious researchers in a serious journal.”

“[It] follows several other research projects that show changes in composition of gut microbe can impact efficacy of immunotherapy,” he said.

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