Its cancer treatment was failed. Planting the intestine microbium around it.

In the spring of 2022, Tim Story doctor told him that he could only have months to live.

Story, a high school coach in Hatsberg, Mississippi, was diagnosed with small bowel cancer in the third stage two years ago, at the age of 49, after mysterious pain on his side turned into a tumor in his small bowel. Surgery and many arduous tours of chemotherapy and immune therapy have failed to stop cancer, which has spread to other organs.

“I am not a man crying, but my wife and wife have threw some tears on the sofa that day,” said Story, 53, said.

However, there was a last option: it can join an extraordinary clinical trial at the MD Anderson Cancer Center in Houston, which has just started recruiting patients. Very experimental-without a guarantee for success-the experiment included obtaining the so-called stool implantation from a patient with advanced cancer that was completely treated with immunotherapy. The idea was that the unique population of the intestine bacteria inside the stool may help start the immune system to better identify and combat cancer.

This came with its own dangers, but the story agreed to register in the trial. “I knew I was a kind of Guinea pig, but the only other option was to stay at home, and I wasn’t going to do it,” he said.

The story did not know this at that time, but his participation in the experiment would help enhance new boundaries of cancer: using the intestinal microbiome to launch the full strength of the immune system.

The immune system and microbium

Early treatment, the story was given an immunotherapy called PD-1 inhibitor. Unlike other types of cancer treatments, immune treatments make fun of the patient’s immune system to fight the tumor.

PD-1 inhibitors have been particularly effective in patients with a type of tumor that contains Unusually large number From DNA mutations compared to other tumors. Such tumors are classified as “high microsatellite instability”, or MSI-H.

Estimate 20 % of small bowel cancers and 20 % -30 % of endometrial cancers It is Msi-H, as well Some melanomic tumors Ovarian cancer.

According to Dr. Tim Yetman, Assistant Director of Translation Research at the Tampa Hospital General Cancer Institute in Florida, PD-1 inhibitors help the immune system to discover these mutations and attack the tumor.

“It is a miracle drug,” said Yeatman. “They were able to treat people without chemotherapy, or radiotherapy or not performing surgery.”

In some cases, Yeatman said, patients suffer from barely certified improvements: people who suffer from just months of living and who are then treated from their illness. In the medical language, this is referred to as “a full response”.

However, the drug does not always work. While the clinical trials of PD-1 inhibitors in small intestinal cancer were limited, I found many studies More than half of patients with advanced disease do not respond to them, even if their tumors are MSI-H.

The MSI-H Story tumor was, but when it was first given PD-1 inhibitors, the medications did not make a remarkable difference.