Research from a team of scientists at Lawson Health Research Institute and Western University suggests that bacteria in the gut affect how prostate cancer patients receive an oral medication called abiraterone acetate. While the influence of the gut microbiome is nothing new, the researchers say their findings add to the plethora of evidence supporting the important role that gut bacteria play in the body.
"Research is beginning to uncover the ways in which the human microbiome influences cancer development, progression, and treatment," explains Brendan Daisley. "Our study highlights a key interaction between a cancer drug and the gut microbiome that results in beneficial organisms with anti-cancer properties."
Their findings, published in Nature Communications, show how gut bacteria metabolize abiraterone acetate in order to reduce harmful organisms while promoting those that fight cancer. This finding provides greater insight on an alternative path to prostate cancer treatment, which is traditionally treated with therapies that reduce tumor-causing hormones called androgens.
"Unfortunately, traditional androgen deprivation therapies are not always effective," explains Dr. Joseph Chin, Lawson Associate Scientist. "In those cases, alternative therapies are explored."
While abiraterone acetate has already been shown to be an effective treatment, understanding the full impact that the drug has on the body – and that the body has on the drug – is crucial to optimizing effectiveness.
"When drugs are taken orally, they make their way through the intestinal tract where they come into contact with billions of microorganisms," says lead researcher Dr. Jeremy Burton. "While it's long been a mystery why abiraterone acetate is so effective, our team wondered if the gut microbiome plays a role."
In conducting their study, the team analyzed stool samples from 68 prostate cancer patients undergoing abiraterone acetate treatment and traditional androgen deprivation therapies. From this analysis, they found that patients' gut microbiomes changed significantly following the ingestion of abiraterone acetate and that androgen levels also decreased. As reports Eureka Alert:
“Bacteria in the gut metabolized the drug leading to a significant increase in a bacterium called Akkermansia muciniphila. Referred to as a 'next-generation probiotic,' this bacterium's relevance has recently been explored in several large cancer studies. It's been shown to facilitate a better response to cancer immunotherapy drugs and it can elicit a wide range of other positive health benefits as well. The increase in Akkermansia muciniphila also led to an increased production of vitamin K2 which is known for anti-cancer properties that can inhibit tumor growth.”
From these findings, the team intends to continue their investigations in order to determine whether fecal transplants could improve responses to oral and immunotherapy cancer treatments. "While more research is needed, we may one day be able to analyze a patient's microbiome to determine the best course of treatment or even influence the microbiome to improve outcomes," says Dr. Burton. "This could lead to a new frontier in personalized medicine."