New understanding of the gut microbiome is transforming skin cancer treatment. Meet some of the experts at the cutting edge

Chances are you’ve already heard two buzzwords taking the medical world by storm: microbiome and immunotherapy. But did you know that they are now being brought together to make a dramatic breakthrough in skin cancer treatment, thanks to the work of dedicated research teams funded by Cancer Research UK?

Funded by Cancer Research UK, consultant oncologist Dr Pippa Corrie (based at Addenbrooke’s Hospital, Cambridge) and her team are co-leading a national study exploring the gut microbiome and how it could support skin cancer treatment. Their research is uncovering how this complex ecosystem of bugs (bacteria, viruses and fungi) could influence immunotherapy outcomes in patients with advanced melanoma.

And just down the road at biotech company Microbiotica, Dr Trevor Lawley’s team is working closely with Dr Corrie to turn these groundbreaking findings into a potentially life-saving new drug.

“Immunotherapy and the realisation of the vital role of the microbiome in human health have both been transformational in recent years,” says Dr Lawley. “Now these two things are coming together to develop a novel class of ‘drugs made from bugs’ to save the lives of cancer patients. Using bugs to fight cancer sounds far out, and we’re so grateful that Cancer Research UK believed in our project and came in early to support us. We’re very excited about the future. The potential is huge.”

Until relatively recently, the microbiome’s role was thought to relate mostly to digestion. But we now know that it’s intricately linked to the immune system in a complex symbiotic relationship and that a diverse, healthy microbiome is vital for robust immunity.

In tandem with this growing realisation, the past decade has seen significant advances in immunotherapy, now a standard type of treatment for patients with advanced melanoma. Immunotherapy works by helping the immune system recognise and attack cancer cells. Just over half of all people with advanced melanoma who have been treated with an immunotherapy combination have survived their disease for at least 10 years. But it’s not effective for everyone.

And that’s where the microbiome could come in.

“Immunotherapy research has revolutionised the treatment of melanoma, even in people with advanced disease,” says Dr Corrie. “But it’s the 50 per cent who it doesn’t work for, or whose disease becomes resistant, that we’re interested in. Our study analysing the microbiomes in advanced melanoma patients suggests that different microbiome signatures are associated with treatment response. Simply put, some patients’ microbiomes support a positive response, while others work against it.”

The two teams have identified the specific bugs that promote a positive response to immunotherapy, which can potentially make the treatment work for people when it didn’t before. Giving the good bugs to melanoma patients should make immunotherapy more effective for more people. That’s the theory anyway. Step forward Dr Lawley and his team to turn it into reality. “Working with Dr Corrie’s team, we’ve come up with a capsule patients can swallow that enables the good bugs to establish themselves in the gut, and hopefully cause an enhanced response to immunotherapy,” he says. “We’re in the early stages of a clinical study which is recruiting patients in both the UK and Europe. It’s looking very exciting, and we should have results next year.”

Both agree that the positive impact of the microbiome on treatment could be immense, but that none of it could happen without funding. “When I started out, melanoma was a deadly disease. But now I can bring hope and give people a genuine expectation of a future,” says Dr Corrie. “But there are three sides to this equation: research, application and funding. And you need all three, united by the common goal of saving lives, for progress to happen.” In 2023-24, Cancer Research UK spent £4m on melanoma research and currently has £18m committed to active skin cancer projects.

Cancer Research UK is the world’s largest charitable funder of cancer research. Through the work of more than 4,000 scientists, doctors and nurses, it carries out world-class research into the prevention, detection and treatment of more than 200 types of cancer. Over the past 50 years, Cancer Research UK’s pioneering work has helped double cancer survival in the UK. And today it’s continuing to save lives, here and around the world.

To find out more about the work Cancer Research UK is doing to beat skin cancer and what the future holds, visit cruk.org