Microbiome and Immuno-oncology therapies: similar research trajectories, by Georges Rawadi

The biotech sector is riding a new innovation wave: I’m referring to the microbiome. 

It will be as ground-breaking as immunotherapy was for cancer treatment in the 2000s. Back then, CAR-T cell-based therapies, using specially altered immune cells to identify and eliminate cancerous cells, represented a quantum leap in cancer treatment. Because of my background, I am very familiar with this field, and I see many similarities between the development of immunotherapy and that of microbiome-based therapies. 

What exactly do they have in common?

Both therapies have emerged from fundamental and descriptive science. In the 2000s, when fundamental researchers started studying immune cells using powerful analytical tools, their aim wasn’t specifically to treat cancer. What they wanted, was to understand the mechanisms that regulate our immune system and its relationship with sick cells. Immuno-oncology emerged from the knowledge built up in this area and led to the development of extremely precise, effective revolutionary treatments for many types of cancer. Checkpoint inhibitors and CAR-T cell-based therapies, for example. 

With these therapies, 20 years elapsed between the initial description of CAR-T cells and the first experiments conducted by Zelig Eshhar in the late 80s to understand and perfect the system. Today, they serve as a genuine alternative to try treat the disease.

As far as the microbiome is concerned, we are at the dawn of an era that will revolutionize the way we design and develop new treatments for chronic illnesses. Research into the microbiome is currently at a fairly similar stage to CAR-T research fifteen or so years ago. Because of their throughput, coverage and affordability, the latest sequencing technologies allow us to explore the entire intestinal microbiome and monitor how it develops over a lifetime. 

Thanks to this fundamental research, not only have we mapped the human microbiome. Most importantly, we have been able to demonstrate that it plays a central role in our organism’s essential functions – in our metabolism, digestion and immune and neurological systems, for example. 

Alongside this epidemiological and descriptive approach, several scientific publications have highlighted the link between an imbalance of the microbiome, or dysbiosis, and the development of chronic illnesses. 

That’s how we first started using commensal bacteria to restore the balance of our intestinal microbiome, and how a new class of medication emerged: live biotherapeutic products or LBPs. 

LBPs contain beneficial live bacteria, which are administered orally to treat illnesses like obesity, type 2 diabetes, and inflammatory, cardiovascular, and neurodegenerative diseases.

They are produced from isolated bacterial strains, taken mostly from the human intestine, which are cultivated ex-vivo in compliance with pharmaceutical quality standards, and then reintroduced into the human body as capsules or pills. 

LBPs are currently experiencing a boom and I am sure that they will soon be licensed for sale since we now have a perfect understanding of science and manufacturing processes in this field. In addition, efforts are clearly being made to clarify the regulatory pathways. LBPs have one major advantage over other live therapies like cell and gene therapies: they are cheap to produce. And that’s a significant factor, given payer pressure, meaning it will be easier for state health systems to cover the cost of the products that are brought to market.

In my opinion, two key issues will determine the success of these microbiome therapies: clinical proof of their efficacy, and a perfect understanding of how they work. LNC Therapeutics believes in LBPs. We are committed to successfully developing these innovative therapies, so they are available for a large number of patients soon. 

Georges RAWADI, CEO LNC Therapeutics