Pancreatic cancer is an aggressive disease that affects up to six-thousand Canadians a year and is the third leading cause of cancer deaths. In a new study a multidisciplinary team of scientists at Lawson Health Research Institute are examining the microbiome in the gut, as a possible gateway to improving treatment outcomes.
“Pancreatic cancer is very hard to treat, partially because when it’s detected, the cancer is usually in a later stage and spreads very quickly,” explains Dr. John Lenehan, Medical Oncologist at London Health Sciences Centre’s London Regional Cancer Program (LRCP) and Associate Scientist at Lawson. “Our best chemotherapy treatments for the average patient, will give them a little less than a year to live.”
With the goal of improving treatments for these patients the research team led by Dr. Saman Maleki, Scientist at Lawson, is studying whether changing the gut microbiome can result in better response to cancer treatments. “We know that the microbiome plays an important role in patients’ response to various forms of systemic treatments such as immunotherapy and chemotherapy for different cancers,” says Dr. Maleki.
Dr. John Lenehan, Dr. Jeremy Burton and Dr. Saman Maleki
This unique study will happen in three stages. The first stage is an observational study to examine fecal samples of 52 patients at LRCP with advanced pancreatic cancer. The second stage will focus on using the samples from these patients in preclinical models to test new combinations of treatments. The final stage of the study will focus on intervention through human clinical trials by modifying a patient’s microbiome with something called a fecal transplant prior to treatment.
“The microbiome is involved in many aspects of cancer development and these organisms aren’t just living in the gut but also within the tumor,” says Dr. Michael Silverman, Lawson Scientist and Chair/Chief of Infectious Diseases at LHSC and St. Joseph’s Health Care London. “We believe that by giving people a fecal transplant, we can change the bacteria that live within the tumor and gut and then optimize the immune response to both the tumour and to treatment, with the goal of improving patient outcomes.”
Dr. Michal Silverman, Lawson Associate Scientist
Fecal transplants involve collecting stool from a healthy donor, preparing it in a lab and safely transplanting it to the patient, in this case with a capsule. The goal is to transplant the donor’s microbiome so that healthy bacteria will colonize in the patient’s gut. “If you think of microbiome, each bacterium is like a little factory and all together they are a giant factory within us producing things we need,” explains Dr. Jeremy Burton, Lawson Scientist who specializes in human microbiome research. “Over time, a person’s diet, medications, and lifestyle can change the microbiome and it can have a big impact to the rest of our body.”
The research team was recently awarded a $450,000 Catalyst 2021 grant from the Weston Family Foundation to conduct this study, which is the first in the world focusing on prospectively modifying the microbiome in pancreatic cancer patients for treatments and outcomes.
“We normally don’t see this in one study where we go through the full spectrum of learning from patients, to looking at treatments, and then moving to a final intervention stage,” explains Dr. Maleki. “This has not been tried in pancreatic cancer before, but we think leveraging the microbiome and improving the immune response can potentially move the needle in this patient population.”
The team is recruiting both pancreatic cancer patients, as well as healthy volunteers for fecal transplant samples. Those interested in helping with fecal transplant donations can contact Dr. Seema Parvathy at 519-646-6100 ext. 61726 or email seemanair@firstname.lastname@example.org