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Immune Enhancement Pre CAR-T
What is immune enhancement pre CAR-T cell therapy? Or should I ask- could enhancing your immune system before you undergo CAR-T cell therapy improve the success of this therapy?
It seems to me that research into the basic idea that the MM patient’s microbiome has a definite impact on the success of CAR-T cell therapy is in its infancy.
What I found most interesting in the study and video linked below is the finding that yes, the intestinal microbiome is important but also that certain antibiotics can harm the patient’s outcome.
Your gut microbiome and CAR-T cell therapy
I am a long-term MM survivor. As I see it, if a MM patient is considering CAR-T cell therapy then they should use the 4 weeks leading up to their procedure to enhance the efficacy of their therapy by enhancing their intestinal microbiome through:
- nutrition
- supplementation and
- lifestyle therapies
Are you considering CAR-T cell therapy? Email me at David.PeopleBeatingCancer@gmail.com with questions about enhancing your gut microbiome.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Intestinal Microbiome May Play a Role in CAR T-Cell Therapy Outcomes
Melody Smith, MD, MS, discusses how the intestinal microbiome influences CAR T-cell therapy outcomes, highlighting the negative impact of certain antibiotics and the potential role of dietary interventions in improving treatment efficacy.
“In the interview, Smith discussed her research into how the intestinal microbiome influences the efficacy and durability of CAR T-cell therapy in patients with hematologic malignancies…
Smith explained that these findings suggest that microbiome composition plays a critical role in CAR T-cell responses. While studies on modifying the microbiome before therapy are still ongoing, she highlights the potential of dietary interventions, such as high-fiber and fermented food diets, to promote a healthier microbiome.
Additionally, Smith noted that chemotherapy and conditioning regimens likely alter the microbiome, but more research is needed to understand their precise impact on CAR T-cell functionality…
Pharmacy Times: How does the composition of the intestinal microbiome influence CAR T-cell efficacy and durability in patients with hematologic malignancies?
Melody Smith, MD, MS: We and others have investigated how the intestinal microbiome modulates car T cell response…
In our studies, we were really curious about this question as to how the microbiome impacts responses following CAR T-cell therapy, and we specifically focused on a cohort of patients who had received CD19 CAR T-cell therapy. We first evaluated medications because we know medications can induce alterations to the microbiome, known as dysbiosis. We, in fact, did find that those patients who received antibiotics in the 4 weeks prior to CAR T-cell therapy, but more specifically antibiotics that target obligate anaerobes such as:
- piperacillin,
- tazobactam,
- imipenem,
- and meropenem [PIM]—
these patients had decreased overall survival as well as progression free survival…
I’ll just mention too that our initial publication was insightful, but it’s been quite encouraging to see subsequent papers now, to date, about 3 papers that have evaluated patient cohorts of recipients of C19 CAR T-cell therapies analyzing the microbiome and have substantiated many of our initial findings…
We also found that those patients who were exposed to PIM in the 4 weeks prior to CAR T-cell therapy had an association of increased immune effector cell-associated neurotoxicity syndrome [ICANS], which is the toxicity that can occur in patients after CAR T-cell therapy.
We didn’t see any association of antibiotic exposure with cytokine release syndrome. Just to note again, that this ICANS association, as well as decreased overall survival, has been seen in other independent cohorts that have been published in the literature….”
immune enhancement pre CAR-T cell therapy immune enhancement pre CAR-T cell therapy