Every five-gram increase of daily fiber intake linked to a 30% lower risk of cancer progression or death.
A new study in patients demonstrates that dietary fiber and probiotics affect gut flora and immunotherapy responses in melanoma patients.
According to the findings, a high-fiber diet is linked to better survival and immunotherapy response.
Numerous human cohorts and preclinical models have now established the impact of the gut microbiome on treatment responsiveness.
A wide range of environmental factors, including food and drug use, influence the human gut microbiota. However, it’s unclear if dietary fiber intake and the usage of commercially available probiotics improve cancer patients’ immunotherapy responses.
Christine Spencer et al. conducted an observational study to learn how dietary choices affect microbiota and clinical responses to immunotherapy. They started by assessing the gut microbiome profiles of 438 melanoma patients.
Immune checkpoint blockade (ICB) medication was given to the vast majority of these patients (87 percent). Patients were asked to fill out a lifestyle survey about antibiotic and probiotic use, as well as a food questionnaire, before starting treatment.
People who filled out the survey and questionnaire didn’t have a big difference in how long they lived without getting cancer if they took probiotics or not. They then wanted to see if dietary fiber consumption had an influence on ICB responsiveness.
Patients who said they ate more fruits, vegetables, legumes, and whole grains met the study’s fiber consumption requirement. In comparison to the 91 patients with insufficient fiber intake, the 37 patients with sufficient fiber intake had a better progression-free survival (median not attained) (median 13 months). A 30 percent lower risk of cancer progression or death was linked to every five grams of daily fiber intake.
They found that more fiber-consuming patients lived longer than those who did not.
When the patients were further divided into groups based on their fiber intake and use of commercially available probiotic supplements, response to immunotherapy was seen in 18 of 22 patients (82 percent) who reported both sufficient fiber intake and no probiotic use, compared to 60 of 101 patients (59 percent) who reported either insufficient fiber intake or probiotic use.
The response was defined as total or partial complete or partial tumor reduction or stable disease for a minimum of six months from the start of treatment.
Probiotic use alone had no statistically significant effect on progression-free survival or the likelihood of responding to immunotherapy.
“Dietary fiber is important for gut health, just as it’s important for overall health, and the two things are very tightly intertwined,” says Carrie Daniel-MacDougall, co-senior author.
“In this study, we saw that dietary fiber also may be important to cancer treatment, which brings us to a point where we can design interventional studies to answer the questions that patients really want answered: ‘Does what I eat now matter and could it impact my treatment outcome?’ We’re united in working to find answers for our patients.”
Further research in preclinical models backed up the authors’ theory that dietary fiber and probiotics regulate the microbiome and that antitumor immunity is harmed in mice fed a low-fiber diet or given probiotics.
The authors believe that ongoing dietary intervention trials in the context of immune checkpoint blockade therapy are crucial for determining if a focused and feasible diet adjustment at the start of treatment can safely and effectively improve outcomes.
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