A high-fiber diet has long been associated with various health benefits, including a lowered risk of certain cancers. However, there is limited knowledge on whether consuming fiber can also aid in the treatment of existing cancer. Dr. Brendan Guercio, an assistant professor of Hematology/Oncology at UR Medicine’s Wilmot Cancer Institute, is leading the way in investigating whether a high-fiber diet can enhance the effectiveness of cancer immunotherapies.
Immunotherapy, a treatment that trains the immune system to combat cancer, is generally well-tolerated and has the potential to control cancer for extended periods. However, the treatment may not be effective for everyone, and predicting its efficacy remains a challenge.
Several studies have shown that the bacteria residing in the gut, which significantly influences the immune system, can impact a patient’s response to immunotherapy. A study involving melanoma patients discovered that individuals who consumed more fiber responded better to immunotherapy.
Dr. Guercio explains that the gut bacteria consume the same nutrients that we do, indicating that providing them with the nutrients they require may positively affect the immune system, considering their interaction with it.
As a medical oncologist specializing in genitourinary cancers, Dr. Guercio is particularly interested in determining whether a high-fiber diet can improve the response to immunotherapies in patients with bladder or kidney cancer.
Before joining Wilmot in 2022, Dr. Guercio conducted a pilot study at Memorial Sloan Kettering, which revealed a connection between a high-fiber diet and the survival rates of bladder cancer patients undergoing immunotherapy. The study, published in the Journal of Clinical Oncology, also indicated a similar trend in patients with renal cell carcinoma (RCC), a type of kidney cancer. However, further research is required to confirm this effect.
In October, Dr. Guercio received the Interdisciplinary RCC Focus Award from the Kidney Cancer Association, which will support his work for one year. The grant will enable him to collect diet information, as well as blood and stool samples, from 120 RCC patients from Wilmot and Memorial Sloan Kettering.
By comparing patients who have not yet commenced immunotherapy with those who have, Dr. Guercio will examine whether the fiber content in their diets impacts the quantity and type of gut bacteria. Additionally, the study will investigate beneficial factors, such as short-chain fatty acids, which are produced by bacteria when they consume fiber and may help prime the immune system to respond to immunotherapy, as suggested by previous research.
Dr. Guercio will also assess patients’ progression-free survival and overall survival rates, as well as whether a high-fiber diet can aid in tumor shrinkage during immunotherapies.
While the preliminary findings are promising, Dr. Guercio emphasizes that diet is not a substitute for standard therapies. He highlights the significance of standard treatments while aiming to determine how to enhance their effectiveness.
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