Adjunctive fecal microbiota transplantation in supportive oncology: Emerging indications and considerations in immunocompromised patients

FMT has gained enormous momentum in the treatment of acute inflammatory and infectious diseases. Despite an encouraging safety profile, FMT has been met with caution in the oncological setting due to perceived infectious risks in immunocompromised patients. Theoretical risks aside, the application o...

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Bibliographic Details
Main Authors: H.R. Wardill, K.R. Secombe, R.V. Bryant, M.D. Hazenberg, S.P. Costello
Format: Article
Language:English
Published: Elsevier 2019-06-01
Series:EBioMedicine
Online Access:http://www.sciencedirect.com/science/article/pii/S2352396419302154
Description
Summary:FMT has gained enormous momentum in the treatment of acute inflammatory and infectious diseases. Despite an encouraging safety profile, FMT has been met with caution in the oncological setting due to perceived infectious risks in immunocompromised patients. Theoretical risks aside, the application of FMT in oncology may stand to benefit patients, via modulation of treatment efficacy and the mitigation of treatment complications. Here, we summarize most recent safety data of FMT in immunocompromised cohorts, including people with cancer, highlighting that FMT may actually provide protection against bacterial translocation via introduction of a diverse microbiome and restoration of epithelial defenses. We also discuss the emerging translational applications of FMT within supportive oncology, including the prevention and treatment of graft vs. host disease and sepsis, treatment of immunotherapy-induced colitis and restoration of the gut microbiome in survivors of childhood cancer. Keywords: Fecal microbiota transplantation (FMT), Supportive oncology, Immunocompromised, Safety, Emerging applications
ISSN:2352-3964