Cachexia is defined as a multifactorial syndrome characterized by an ongoing loss of muscle mass that cannot be reversed by conventional nutritional support. The syndrome leads to progressive functional impairment, reduced tolerance to anticancer treatments and shorter survival times. Gastroesophageal cancer (GEC) patients are particularly at risk as their mechanical and digestive problems lead to loss of appetite and early satiety. Gut microbiota appears to play a crucial role in regulating certain aspects of cancer cachexia, such as satiety, appetite, host metabolism, systemic inflammation or modulation of the response to certain anticancer drugs. However, this role is impaired by cancer and most anticancer treatments that alter the intestinal barrier. Hence the idea to study the effects of fecal microbiota transplantation (FMT) on cachexia in GEC patients.

Study parameters: satiety, survival, and gut microbiota

This double-blind, randomized, controlled study was conducted on 24 cachectic patients with inoperable metastatic GEC undergoing palliative chemotherapy. These patients received allogenic FMT (treatment group; healthy overweight or obese donor) or autologous FMT (control group; donor = patient). The primary research objective was to evaluate the effect of FMT on satiety. Other characteristics of cachexia were also monitored, as well as the effectiveness of chemotherapy and survival. Lastly, exploratory analyses measured the effect of FMT on the composition of the gut microbiota.

No impact on satiety, but beneficial effect on disease progression

Contrary to expectations, allogenic FMT from a healthy obese donor did not improve the recipient's satiety or cachexia before chemotherapy. It nevertheless appears to have had a beneficial effect on disease progression: when compared to the control group, the 12 patients in the treatment group had a better disease control rate (based on RECIST criteria) at 12 weeks, and longer overall (365 vs. 227 days) and progression-free survival (204 vs. 93 days). Three patients in the control group and none in the treatment group died of cancer before the end of the study. The patients' fecal microbiota also changed after allogenic FMT, indicating proper engraftment of the donor microbiota despite chemotherapy. The researchers were unable to identify specific gut bacterial species associated with chemotherapy outcomes in the treatment group. FMT studies on a larger scale will be needed. Ultimately, the hope is for personalized treatments, via the administration of prebiotics and probiotics specifically adapted to a patient's microbiota to improve the effectiveness of anticancer drugs.

Cachexia brings forward images of weakened hunger strikers or patients in their last days of life. It is a state of extreme fatigue and emaciation and a sign of severe malnutrition or the terminal phase of certain diseases, such as gastroesophageal cancer. It is well known that gut microbiota seems to play a crucial role in the regulation of appetite, which cancer patients lack. This gave these researchers an idea, namely to implant their patients with gut flora from healthy obese donors since some of these microorganisms (sidenote: Microorganisms Living organisms that are too small to be seen with the naked eye. They include bacteria, viruses, fungi, archaea and protozoa, and are commonly referred to as “microbes”. What is microbiology? Microbiology Society. ) may have played a role in their weight gain.

No improvement in appetite but beneficial effect on cancer progression

Twenty-four cachectic patients with inoperable gastroesophageal cancer who were to receive palliative chemotherapy participated in the study. Twelve received flora from a healthy overweight or obese donor while the other twelve received their own microbiota (control group). No one knew who was receiving what so as not to influence the outcome. Contrary to the expectations of the researchers, allogenic FMT from a healthy obese donor did not improve the recipient's satiety or cachexia before chemotherapy. It nevertheless seems to have had a beneficial effect on the progression of the disease. Compared to the control group (which received its own flora), the cancer was better controlled in the 12 patients who received microbiota from an obese donor. Their survival was also improved. 

Gut bacteria and the effectiveness of chemotherapy? 

An analysis of their new fecal microbiota confirmed that the gut flora transplant was successful despite the chemotherapy that followed. However, it is impossible for the researchers to know at this stage whether certain specific gut bacterial species could lead to more effective chemotherapy treatment. Studies on a larger scale will be needed to find out more. While waiting for the next findings, follow the news of the Institute but do not under any circumstances try to make a home-made gut flora cocktail!

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Through its ability to connect millions of people, Twitter is currently the most popular form of social media used for healthcare communication. The Microbiota Institute joins the social media with one goal: raising a qualified community by creating an engaging dynamic around the latest microbiota news.

Building an international HCPs community around microbiota...

Latest scientific publications, experts’ interviews, thematic folders, live-tweet of conferences (WGO, ESPGHAN, etc.) ... Healthcare professionals will have access to a wide range of up-to-date scientific content. This new Twitter account (@Microbiota_Inst) is designed aiming to reach the widest community of health professionals who want to be up to date with the latest information on the microbiota field. Health professionals but not only. Thanks to this new communication channel, the Microbiota Institute wants to expand its audience by reaching recognized scholarly societies, healthcare students but also the specialized press, congresses, professional orders...

... And promoting the latest therapeutic advances and the power of microbiota on health

By sharing accurate news about microbiota either from the Institute exclusive website content  (digest of research advances for clinical practitioner) or from other HCPs’ tweets, the Institute Twitter account aims to be recognized as a useful and trustful partner when it comes to research and clinical practice. Twitter is THE social network to follow in order to know and spread microbiota scientific knowledge. As a recognized international platform on that field, it was legitimate for the Institute to strengthen its presence on this channel.

About the Microbiota Institute

The Biocodex Microbiota Institute is an international scientific institution that aims to foster health through spreading knowledge about the human microbiota. To do so, the Institute addresses both healthcare professionals and the general public to raise their awareness about the central role of this still mis known organ of the body. 

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Free accredited courses, available in 7 languages 

The training set is composed of 4 one-hour accredited courses. You just have 5 minutes? No problem, each hour is composed of several micro-learning videos. An evaluation test is available at the end of the course to get official European Continuing Medical Education credits provided by the European Accreditation Council on Continuing Medical Education. The courses are available in 7 languages: English, French, Spanish, Russian, Polish, Turkish and Portuguese. Made possible thanks to an unrestricted grant by the Biocodex Microbiota Institute, these courses are completely free and available exclusively on the Xpeer app. 

Book a private mentoring session with an expert on the Xpeer app 

The first session, available on May 2021, will be dedicated to Drugs and Gut microbiota. Lead by Professor Francisco Guarner Aguilar, MD, PhD, a gastroenterologist and senior researcher at the Vall d’Hebron Research Institute, this course is made for HCPs with medium level of knowledge on microbiota. Thanks to a visual summary composed with 3 recommendations and 3 concepts to revisit, the healthcare professional can use immediately what he/she learns with his/her next patient. Exclusive: the HCPs can also book a private mentoring session with an Pr Guarner on the Xpeer app. Don’t wait, get microbiota certified! 

What is Xpeer?

Xpeer Medical Education is the first accredited medical education app in the market, with video microlearning engaging videos of just 5 minutes. With a powerful algorithm to personalize the user experience and the contents as the most popular entertaining streaming platforms, it offers a brand new experience for the continuing education and professional development of the healthcare professionals. Accredited by the European Union of Medical Specialists, it delivers high quality scientific medical education pieces. On Xpeer, you will find this curriculum on Microbiota and 500 hours of medical education in 2021 in your specialty, technologies and professional and personal skills.

About the Microbiota Institute

The Biocodex Microbiota Institute is an international scientific institution that aims to foster health through spreading knowledge about the human microbiota. To do so, the Institute addresses both healthcare professionals and the general

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