Should screening of the gut microbiome be standard practice for patients with melanoma?

Source: Healio, January 2020

Yes.

We should screen the gut microbiome of our patients with melanoma. Currently, this practice is not necessary for treatment or clinical decision-making, but rather for research that could eventually lead us to the point of clinical impact.

The gut microbiome is an incredibly rich but untapped source of information. Human DNA encodes for approximately 20,000 proteins. Conversely, the gut has a number of bacteria species and DNA that code for millions of proteins. We are learning more every day about how the gut microbiome applies to human development, physiology and pathology. From embryonic development and the maternal immunity that babies are born with, to an immune system that evolves through time in response to environment, behavior and medications, we see that these changes may be influenced by microbial species in the gut. This research is important in that it may help us understand a range of human disease, including cancer, and how it responds to immunotherapy.

For oncologists, the holy grail is to know who will respond to checkpoint inhibitors, which are still a relatively new treatment for melanoma and many other types of cancer. There were no effective treatments for melanoma until checkpoint inhibitors came out, so anything more we can learn about who will respond will be incredibly important.