Two Cases of Durable and Deep Responses to Immune Checkpoint Inhibition-Refractory Metastatic Melanoma after Addition of Camu Camu Prebiotic

Steph A Pang; Arielle Elkrief; Mariana Pilon Capella; Wilson H Miller Jr

doi:10.3390/curroncol30090570

$Two Cases of Durable and Deep Responses to Immune Checkpoint Inhibition-Refractory Metastatic Melanoma after Addition of Camu Camu Prebiotic$

Journal article

Open access

Peer reviewed

Two Cases of Durable and Deep Responses to Immune Checkpoint Inhibition-Refractory Metastatic Melanoma after Addition of Camu Camu Prebiotic

Steph A Pang, Arielle Elkrief, Mariana Pilon Capella and Wilson H Miller Jr

Current oncology (Toronto), Vol.30(9), pp.7852-7859

08/25/2023

DOI: 10.3390/curroncol30090570

PMCID: PMC10528119

PMID: 37754485

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Abstract

Camu camu (CC) is a prebiotic that selectively stimulates growth and activity of beneficial gut microbiota. Work in murine models demonstrated that castalagin, the active compound in CC, preferentially binds to beneficial gut microbiome bacteria, promoting a stronger CD8+T cell anti-cancer response. We present two patients with metastatic melanoma whose cancer progressed on immune checkpoint inhibitors (ICIs) and developed clinically significant immune-related adverse events (irAEs). They were rechallenged with ICIs in combination with CC. The first patient is a 71-year-old woman with metastatic melanoma, whose ICI treatment was complicated by immune-related pneumonitis and colitis. Upon progression on maintenance nivolumab, CC was added to nivolumab, leading to a near complete response (CR). The second patient is a 90-year-old man with recurrent unresectable melanoma, treated with nivolumab, complicated by immune-related rash and diabetes. He developed new subcutaneous calf lesions and a metastatic popliteal lymph node. CC was added to nivolumab. One month later, the patient experienced a CR. Both patients have been on nivolumab and CC with durable responses for more than a year, with minimal irAEs. These two cases suggest that CC may modulate the microbiome, synergizing with ICIs to produce deep, durable responses with minimal irAEs.

Aged

Aged, 80 and over

Animals

Antineoplastic Agents, Immunological - adverse effects

Female

Humans

Immune Checkpoint Inhibitors - therapeutic use

Male

Melanoma - drug therapy

Melanoma - pathology

Melanoma, Cutaneous Malignant

Mice

Neoplasm Recurrence, Local

Nivolumab - therapeutic use

Details

Title: Subtitle: Two Cases of Durable and Deep Responses to Immune Checkpoint Inhibition-Refractory Metastatic Melanoma after Addition of Camu Camu Prebiotic
Creators: Steph A Pang - Jewish General Hospital
Arielle Elkrief - Centre Hospitalier de l’Université de Montréal
Mariana Pilon Capella - Jewish General Hospital
Wilson H Miller Jr - McGill University
Resource Type: Journal article
Publication Details: Current oncology (Toronto), Vol.30(9), pp.7852-7859
DOI: 10.3390/curroncol30090570
PMID: 37754485
PMCID: PMC10528119
NLM abbreviation: Curr Oncol
ISSN: 1718-7729
eISSN: 1718-7729
Grant note: CIHR
Language: English
Date published: 08/25/2023
Academic Unit: Internal Medicine
Record Identifier: 9984946624202771

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