While immune checkpoint inhibitors have evolved into the standard of care for advanced melanoma, 40–50% of melanoma cases progress while on therapies. The relationship between bacterium and carcinogenesis is well founded, such as inH. pyloriin gastric cancers, andFusobacteriumin colorectal cancers. This interplay between dysbiosis and carcinogenesis questions whether changes in the microbiome could affect treatment. Thus, FMT may find utility in modifying the efficacy of anti-PD-1. This review aims to examine the use of FMT in treatment-resistant melanoma. A literature search was performed using the keywords “fecal microbiota transplant” and “skin cancer”. Studies were reviewed for inclusion criteria and quality and in the final stage, and three studies were included. Overall objective responses were reported in 65% of patients who were able to achieve CR, and 45% who achieved PR. Clinical benefit rate of combined CR/PR with stable disease greater or equal to 6 months was 75%. Reported objective responses found durable stable disease lasting 12 months. Overall survival was 7 months, and overall PRS was 3 months. As for the evaluation of safety, many patients reported grade 1–2 FMT related AE. Only following the administration of anti-PD-1 therapy were there a grade 3 or higher AE.
尽管免疫检查点抑制剂已成为晚期黑色素瘤的标准治疗方案，但仍有40-50%的患者在接受治疗期间出现疾病进展。细菌与癌变之间的关联已得到充分证实，例如幽门螺杆菌与胃癌、梭杆菌与结直肠癌的关系。菌群失调与癌变之间的相互作用引发了一个问题：微生物组的改变是否会影响治疗效果。因此，粪便微生物移植可能具有调节抗PD-1疗法疗效的作用。本综述旨在探讨FMT在治疗耐药性黑色素瘤中的应用。通过关键词"粪便微生物移植"和"皮肤癌"进行文献检索，对符合纳入标准和质量要求的研究进行筛选，最终纳入三项研究。总体客观缓解率显示：达到完全缓解的患者占65%，部分缓解患者占45%。完全缓解/部分缓解联合疾病稳定≥6个月的临床获益率达75%。研究报道的客观缓解表现为持续12个月的长期疾病稳定。患者中位总生存期为7个月，中位无进展生存期为3个月。安全性评估方面，多数患者报告了1-2级FMT相关不良事件，而3级及以上不良事件仅发生在接受抗PD-1治疗后。
肿瘤(癌症)患者之家