# Prebiotic diet intervention to enhance the microbiome and immunotherapy response in melanoma

> **NIH NIH R01** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2024 · $678,399

## Abstract

PROJECT SUMMARY
Treatment with immune checkpoint inhibitors (ICI) has been revolutionary in melanoma and other cancers.
However, only a subset of patients will have durable responses to first-line therapy and immune-related
toxicities remain a significant challenge. Given the critical, unmet need for safe, effective and broadly
applicable strategies in this setting, we will conduct a prebiotic food-enriched diet (PreFED) intervention
combined with standard-of-care ICI in metastatic melanoma patients. This study seeks to intervene on insights
from our own work and others demonstrating that (1) gut microbiome profiles and dietary habits predict
response to ICI in melanoma; (2) well-characterized gut commensals consistently implicated in ICI response
are highly responsive to prebiotic dietary interventions; and (3) the gut microbiome is a therapeutic target in
ICI-induced toxicities. With the overarching goal to test rationally-designed, microbiome-targeted dietary
interventions that cancer patients undergoing active therapy can practically implement and sustain throughout
treatment, PreFED is a scalable approach focused on providing multiple key microbiota-accessible nutrients
through provision of prebiotic foods and nutritional counseling to selectively stimulate beneficial gut microbes
that enhance and sustain the overall gut ecosystem. Nutrient and microbiota-derived metabolites from these
interactions support the central mechanisms underlying a favorable immune response to ICI (e.g., balancing
inflammation and effector T-cell function). Thus to further interrogate mechanism and test whether PreFED-
manipulation of the microbial community could be effective as an adjunctive therapy to ICI, we will transplant
paired patients’ fecal samples into germ-free mice to examine the impact of post vs. pre-diet microbiome on
melanoma growth and ICI response, as well as mucosal and anti-tumor immunity. Through these studies, we
will evaluate the effect of the PreFED on the gut microbiome, host metabolome, and the mucosal, systemic
and antitumor immune response to ICI. Integrative analyses of both human and mouse studies will provide
significant insights on diet-induced changes in the microbiome and microbiota-mediated changes in the
metabolome that influence the immune response to ICI – and highlight avenues whereby patients’ diets may
influence the success of other microbiome-targeted strategies being developed in this setting. Notably, to
progress to future multicenter trials with robust translational and clinical endpoints, we will define the safety and
efficacy profile of PreFED as an adjunct to current ICI regimens (anti-PD1 monotherapy, anti-PD1+LAG3, anti-
PD1+CTLA4). Though our studies will focus on metastatic melanoma, dietary approaches to enhance the gut
microbiome, anti-tumor immunity and ICI response are relevant and applicable to other stages and cancer
types. Accessible, appropriately refined and successful dietary interventions offer a cost-...

## Key facts

- **NIH application ID:** 10939497
- **Project number:** 1R01CA291965-01
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Carrie Daniel-MacDougall
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $678,399
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10939497

## Citation

> US National Institutes of Health, RePORTER application 10939497, Prebiotic diet intervention to enhance the microbiome and immunotherapy response in melanoma (1R01CA291965-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10939497. Licensed CC0.

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