# The role of the intestinal microbiome in cancer immunotherapy

> **NIH NIH R35** · BECKMAN RESEARCH INSTITUTE/CITY OF HOPE · 2024 · $1,014,601

## Abstract

ABSTRACT
The gut microbiota consists of a community of diverse microbes and has many effects on human
(patho)physiology. Microbiome composition has been associated with many diseases, but causal inference is
often lacking. Preclinical and clinical studies have demonstrated that the intestinal microbiota can regulate innate
and adaptive immunity, including T cell and antitumor immunity after allogeneic hematopoietic cell
transplantation (allo-HCT) and checkpoint blockade. My lab has focused on the role of gut microbiota in
outcomes of allo-HCT and immunotherapy. For example, we showed that microbiota composition undergoes
significant and frequent changes during allo-HCT and that lower intestinal microbiota diversity is associated with
increased mortality. We also found that dominance by certain species, most frequently Enterococcus, is
associated with lethal graft-versus-host disease (GVHD); that exposure to certain antibiotics is associated with
worse outcomes following allo-HCT and chimeric antigen receptor T cell (CART) therapy; and that hematopoietic
reconstitution is associated with the presence of beneficial flora. These studies have been translated into clinical
trials using autologous fecal microbiota transplant, administration of defined bacterial consortia, and antibiotic
stewardship to spare and/or restore the commensal flora. The overarching hypothesis of this proposal is that the
intestinal microbiome is an important modulator of innate and adaptive immunity in the setting of cancer
immunotherapy. While immunotherapies are curative in some recipients, improving their efficacy and abating
toxicities are unmet needs in oncology. The major goals are to improve cancer immunotherapy by targeting the
intestinal microbiome based on preclinical and clinical studies. Examples of our ongoing and planned studies
include: a) development of a new pipeline for microbiome analysis, b) preclinical and clinical projects regarding
intestinal microbiome and CART, c) new techniques to analyze the effects of diet and drugs on the intestinal
microbiome, and d) preclinical and clinical studies regarding immune modulation by bile acids, as an example
how we study the mechanisms by which the intestinal microbiome can modulate immunity and cancer
immunotherapy. We have organized a multicenter global consortium to collect fecal samples (funded separately
from this application) along with a novel multi-omic approach to integrate patient, microbiome, and tumor profiling
modalities using a computational platform (MSK-MIND) for data harmonization and machine learning. These
investigations will be performed via perpetual dialogue between work with mice and humans: human studies
enable us to observe correlations, develop hypotheses, and test therapeutic strategies; animal studies enable
us to establish or refute causal relationships between microbiota and host immunology and to obtain mechanistic
insights. These data will inform the future development of clinical tri...

## Key facts

- **NIH application ID:** 10890871
- **Project number:** 5R35CA284024-03
- **Recipient organization:** BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
- **Principal Investigator:** Marcel R M van den Brink
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,014,601
- **Award type:** 5
- **Project period:** 2023-08-01 → 2030-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10890871

## Citation

> US National Institutes of Health, RePORTER application 10890871, The role of the intestinal microbiome in cancer immunotherapy (5R35CA284024-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10890871. Licensed CC0.

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