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Lawson Research Institute scientists have perfected the delivery of fecal transplants via patient-friendly capsules now central in ground-breaking cancer treatment studies.

It’s one of the most exciting areas of research in cancer care.

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Making waves in scientific and health care circles worldwide, it holds the potent potential to “jazz up” cells that attack cancer and boost the body’s response to treatment.

So what is this powerful ally?  It’s poop in a pill – home-grown right here at St. Joseph’s Health Care London and Lawson Research Institute.  

In fact, Lawson scientists Dr. Michael Silverman, Seema Nair Parvathy, PhD and their team are considered poop pill pioneers, having perfected the delivery of fecal transplantation by way of patient-friendly capsules that can be easily swallowed. These capsules contain healthy gut microbes that have become pivotal in many landmark cancer treatment studies.

Triggering an immune response

Understanding the role of poop in cancer treatment requires grasping the wonders of the human microbiome and its key role in influencing health and well-being.  

The human microbiome consists of trillions of microorganisms that live inside and outside of the body, including bacteria, viruses and yeasts. While some bacteria are associated with disease, others are vital to the human immune system – the body’s main protective and disease-fighting tool – and many other aspects of health. Over the past decade, microbiome research has led to a revolution in medicine as scientists unravel just how an imbalance of these microorganisms interferes with many aspects of good health.

 "(Fecal microbial transplants) allows us to harness the immune system to mount a stronger defence." Dr. Michael Silverman

The goal of fecal microbiota transplants (FMT) is to transfer healthy gut microbes from donors into patients with cancer and other diseases so that healthy bacteria will colonize in the patient’s gut and improve the microbiome, explains Silverman, Medical Director of St. Joseph’s Infectious Diseases Care Program and citywide Chief of Infectious Diseases for London’s hospitals.  

To do so, stools are collected from carefully screened healthy donors, prepared in a lab into capsule format, and introduced into a patient’s gastrointestinal tract.  

“What is so exciting when it comes to cancer treatment is the evidence we now have showing how a healthy microbiome activates the immune response to tumours to make the treatment more effective,” Silverman adds. “It allows us to harness the immune system to mount a stronger defense.”

St. Joseph’s capsules are central to several significant studies currently underway aimed at improving treatment for lung, kidney, breast, renal, pancreatic and other cancers.  

Among the most notable is the London team’s lead role in a ground-breaking national study – one of the world’s largest randomized controlled clinical trials using FMT to improve the effectiveness of the standard of care for advanced melanoma, a type of skin cancer.

Improving melanoma survival rates

About 11,300 Canadians will be diagnosed with melanoma in 2024 and, even with standard treatment, about half that number will experience disease progression and die.  

The 16-site Canadian trial builds off the work of Silverman, Parvathy and their team, in partnership with Saman Maleki, PhD, and Dr. John Lenehan at London Health Sciences Centre. Together, they were the first to demonstrate the safety and therapeutic potential of using the capsules produced at St Joseph’s to influence a patient’s gut microbiota to enhance immunotherapy and increase the odds of surviving advanced melanoma.  

“London is seen as having the most expertise in use of FMT in cancer care in the world and is a driving force in moving this forward,” says Silverman. “Immunotherapy is rapidly expanding the number of treatable cancers and our FMT therapy is helping to accelerate this progress.”