Our previous work (dx.doi.org/10.2139/ssrn.319999...) at MD Anderson Cancer Center demonstrated that both the vaginal microbiome and gut microbiome are closely related to immune system response and treatment response for HPV-related cervical cancers. In our study, patients underwent standard of care chemoradiation for cervical cancer. Patients with increased gut diversity and lack of lactobacillus dominance in the vaginal microbiome responded better to treatment and had longer periods of time without recurrence. Other recent data from our institution and others published in Science has also shown that an optimized gut microbiome results in improved response to immunotherapy and chemotherapy in multiple cancers. Additionally, our group has studied the role of the gut microbiome in radiation-related toxicity for cervical cancer patients and other patients undergoing pelvic radiation therapy. This therapy results in diarrhea, bowel incontinence, and rectal pain which can make treatment very difficult for patients. Decreased microbiome diversity at the end of treatment seemed to be related to worse radiation-related diarrhea.
In radiation therapy clinic, we have for decades given patients undergoing pelvic radiation therapy specific nutritional advice designed to decrease this diarrhea: eat bland foods, no leafy vegetables, no fresh fruits, and avoid fiber. Dietitians see these patients on a weekly basis and help them modify their diets to decrease diarrhea in order to make it through radiation treatment. Our study findings raised suspicions of this advice: Are we giving patients advice that may actually decrease their gut microbiome's ability to generate an immune response and fight their cancer?
In this study, we propose using a patient-centered approach to involve patients receiving pelvic radiation therapy (gynecologic cancers including cervical, vulvar and vaginal cancers, anal cancers, rectal cancers, prostate and bladder cancers) in a prospective study to use real-time microbiome feedback via uBiome to encourage dietary habits that result in microbiome optimization. All patients will undergo microbiome evaluation including SmartGut prior to treatment. They will then be given dietary counseling by our registered dietitians including increased fiber intake, eating a variety of legumes, beans, fruits and vegetables, yogurt and other fermented foods, eating a variety of non-processed meat sources, and decreasing sugar intake. Patients will receive real-time feedback every two weeks throughout the course of radiation. Radiation-related toxicity will be evaluated using a well-validated bowel toxicity questionnaire that has been used in our previous study. We have a previous comparison cohort of patients who underwent gut microbiome evaluation every two weeks without dietary counseling or real-time feedback.
Patients with gynecologic cancer will undergo vaginal sampling with SmartJane. Baseline SmartJane samples will be completed and discussed with patient prior to the initiation of chemo-radiation treatment. The normal microbial flora of the vagina will be compared across cancer histology, grade, stage, as well as patient age and race. Vaginal bacterial abundance will be determined using SmartJane with particular attention given to identifying health associated lactobacillus species (L. Crispatus, L. Jensenii, and L. Gasseri).
We see approximately 20-40 new pelvic radiation therapy patients per week, and anticipate this study could have an enormous impact on cancer patients across a variety of disease sites, as approximately 60% of newly diagnosed cancer patients in this country receive radiation therapy. We are incredibly excited about the opportunity to engage patients in this research by using real-time patient-oriented microbiome feedback via the SmartGut and SmartJane platforms.
Easy one-click social registrationIs this safe?
We only receive the minimum information necessary to verify your account. We never get access to your friends/contacts or your profile, and we never post on your behalf. Your social account is used for logging in only.ORRegister via email
Send me updates on this Challenge
In order to ensure a fair voting process and to make sure that no one votes more than once, we ask that you register either with a social networking account (easiest, only requires one click) or by registering with your email address (this will require you to click on a verification email that we will send you).
You only need to register once.