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Scientists examining microbiome to improve cancer therapies

MEDIA RELEASE 
For Immediate Release 

LONDON, ON- 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.

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.”

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@@email

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LONDON, ON – Transitional aged youth in Middlesex County now have access to a free transportation resource to access mental health services. Called the County Transport initiative, it will help youth ages 16 to 25 in Lucan, Parkhill, Exeter and Strathroy-Caradoc get the mental health care they need, when they need it.  

County Transport is being coordinated by MINDS of London-Middlesex, a program of Lawson Health Research Institute, in partnership with the Canadian Mental Health Association (CMHA) of Elgin-Middlesex, Star Taxi and Middlesex County through the Lucan and Parkhill Libraries.  

“Through our collaborative work, we’ve heard from many youth that transportation is a barrier for them when trying to access mental health services when in crisis. Youth in rural areas find this very challenging since most services are not close to their location,” says Romaisa Pervez, Research Assistant at MINDS of London-Middlesex.  

MINDS, a Mental Health INcubator for Disruptive Solution, is a social innovation lab with a mission to address the complexity of the mental health care system. Youth with lived experience, community members and researchers work together to understand and help those living with mental health challenges in London-Middlesex by designing, piloting and testing innovative solutions developed locally.  

“We do not have the exact numbers of Transitional Aged Youth (TAY) living in rural Middlesex who would benefit from access to the County Transport Initiative, but we know that mental health services in rural communities are limited and that access to the services available in larger city centres is challenging due to transportation difficulties,” explains Cathy Burghardt-Jesson, Warden for Middlesex County. “Transportation from Middlesex to London, where the majority of mental health resources are located, is underdeveloped as there are limited bus routes and schedules. This leaves little in the way of affordable transit options for TAY in crisis.”  

Youth in crisis who connect with CMHA’s Reach Out 24/7 line at www.reachout247.ca or by phone at 519-433-2023 will be supported and assessed by the Crisis Line staff. If it is determined that a visit to the London Crisis Centre is needed, the CMHA Crisis worker will ensure a smooth transition from the Crisis Line to the Star Taxi Service. The youth will be provided with free transportation to and from CMHA’s Mental Health and Addictions Crisis Centre located at 648 Huron Street.  

To ensure the safety and wellbeing of the youth accessing this service, Star Taxi drivers have received training developed by CMHA regarding mental health and crisis de-escalation, as well as suicide prevention training by Living Works. 

Funding for the initiative has been provided by St. Joseph’s Health Care Foundation and the generous support of individual donors in the community. 

“With additional funding, the initiative could be scaled up to reach as many youth as possible in Middlesex County and beyond. We want to see all youth in rural areas who want to access mental health services able to do so, by removing the barriers of location and transportation,” adds Pervez. They will be collecting information regarding use of the transportation service and youth experience to refine and improve the initiative.  

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LONDON, ONTARIO - For patients with kidney stones, ureteral stents (hollow devices placed in the ureter – the tube between the kidney and bladder) can be used temporarily to relieve urinary obstruction. Despite the use of antibiotics, ureteral stents often become encrusted with minerals and coated with bacteria. This can lead to complications like infection and the need for replacement surgery. 

Published today in Cell Reports Medicine, researchers at Lawson Health Research Institute and Western University conducted a novel microbiome study to examine bacteria associated with ureteral stents. They found that nearly all the stents, whether visibly coated or not, had unique bacterial profiles that were most associated with a patient’s medical condition rather than antibiotic use. For patients with ureteral stents, they may benefit from a personalized approach to care and antibiotic treatment. 

The study included 241 patients from St. Joseph’s Health Care London. The research team collected and analyzed patient urine samples and ureteral stents following surgical removal, as well as relevant patient information such as antibiotic use and history of infections.  

“We wanted to know which bacteria were present and whether the bacteria found in urine samples corresponded to the bacteria found on a patient’s stent,” explains Dr. Kait Al, Postdoctoral Fellow at Lawson and at Western’s Schulich School of Medicine & Dentistry. “We found that there was a bacterial community present on almost all stents, even if they were not visibly affected, and that it differed from the bacterial community found in a patient’s urine.”

These findings challenge long-held beliefs that the urinary tract is a sterile environment devoid of bacteria.

The study revealed that the bacteria present were determined by an individual patient’s medical condition. They differed significantly based on comorbidities like irritable bowel syndrome, obesity and hypertension. Antibiotic use within the past 30 days did not seem to have an effect on the types of bacteria detected on the stents. 

“While more research is needed, our study suggests that antibiotic use during the placement of these stents could one day be more conservative or targeted based on each patient’s condition,” says Dr. Jeremy Burton, Lawson Scientist and Associate Professor at Schulich Medicine & Dentistry.

The team also discovered that in patients needing multiple stents, the bacterial community remained stable over time, suggesting that infections on a patient’s previous stent could direct the course of treatment for their future device placements. 

“This is the largest study of its kind, investigating bacteria both in urine and adhered to ureteral stents,” states Dr. Hassan Razvi, Urologist at St. Joseph’s, Lawson Associate Scientist and Professor at Schulich Medicine & Dentistry. “We hope this will be the first step towards personalized care, ultimately leading to fewer stent-associated infections.” 

The study was made possible through the generous support of The W. Garfield Weston Foundation and St. Joseph’s Health Care Foundation.

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Scanning electron microscopy images showing organic material, crystals, and bacteria present on the surface of the ureteral stents.

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Recovered ureteral stent encrusted with minerals and bacteria. 

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