Lady Davis Institute and Segal Cancer Centre, Jewish General Hospital, Departments of Medicine and Oncology, McGill University, Montréal, QC H3T 1E2, Canada.
Hematology-Oncology Division, Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC H2X 3E4, Canada.
Curr Oncol. 2023 Aug 25;30(9):7852-7859. doi: 10.3390/curroncol30090570.
Camu camu (CC) is a prebiotic that selectively stimulates growth and activity of beneficial gut microbiota. Work in murine models demonstrated that castalagin, the active compound in CC, preferentially binds to beneficial gut microbiome bacteria, promoting a stronger CD8+T cell anti-cancer response. We present two patients with metastatic melanoma whose cancer progressed on immune checkpoint inhibitors (ICIs) and developed clinically significant immune-related adverse events (irAEs). They were rechallenged with ICIs in combination with CC. The first patient is a 71-year-old woman with metastatic melanoma, whose ICI treatment was complicated by immune-related pneumonitis and colitis. Upon progression on maintenance nivolumab, CC was added to nivolumab, leading to a near complete response (CR). The second patient is a 90-year-old man with recurrent unresectable melanoma, treated with nivolumab, complicated by immune-related rash and diabetes. He developed new subcutaneous calf lesions and a metastatic popliteal lymph node. CC was added to nivolumab. One month later, the patient experienced a CR. Both patients have been on nivolumab and CC with durable responses for more than a year, with minimal irAEs. These two cases suggest that CC may modulate the microbiome, synergizing with ICIs to produce deep, durable responses with minimal irAEs.
卡姆果（CC）是一种益生菌，能选择性地刺激有益肠道微生物群的生长和活性。在鼠类模型中的研究工作表明，CC 中的活性化合物鞣花丹宁优先与有益的肠道微生物群细菌结合，促进更强的 CD8+T 细胞抗癌反应。我们报告了两名转移性黑色素瘤患者的病例，他们的癌症在免疫检查点抑制剂（ICI）治疗下进展，并出现了临床上显著的免疫相关不良事件（irAEs）。他们接受了 ICI 联合 CC 的重新挑战。第一个患者是一名 71 岁的女性，患有转移性黑色素瘤，她的 ICI 治疗因免疫相关性肺炎和结肠炎而复杂化。在维持纳武利尤单抗治疗时出现进展后，CC 被添加到纳武利尤单抗中，导致接近完全缓解（CR）。第二个患者是一名 90 岁的男性，患有复发性不可切除黑色素瘤，接受纳武利尤单抗治疗，并发免疫相关性皮疹和糖尿病。他出现了新的小腿皮下病变和一个转移性腘淋巴结。CC 被添加到纳武利尤单抗中。一个月后，患者达到了 CR。两名患者均接受了纳武利尤单抗和 CC 联合治疗，缓解持续超过一年，irAEs 很少。这两个病例表明，CC 可能调节微生物组，与 ICI 协同作用，产生深度、持久的缓解，irAEs 很少。
