Peer-reviewedCC BY-NC-ND 4.0Cell Reports Medicine
First-line fecal microbiota transplantation for the management of immune checkpoint inhibitor-mediated diarrhea and colitis
17 affiliations
- 1Department of Gastroenterology, Hepatology & Nutrition, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 2Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 3Division of Gastroenterology and Hepatology, Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
- 4Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX, USA
- 5Department of Medicine, Weill Cornell Medical College, New York, NY, USA
- 6Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 7Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 8Metabolomics Core Facility, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 9Proteomics Core Facility, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 10Division of Infectious Disease, Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
- 11The University of Texas Health Science Center at Houston, McGovern Medical School, Department of Internal Medicine, School of Public Health, Houston, TX, USA
- 12Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
- 13Departments of General Internal Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
- 14Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 15Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 16Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- 17Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
Abstract
Immune checkpoint inhibitor (ICI) therapy commonly leads to adverse events such as ICI-mediated diarrhea and colitis (IMDC). Fecal microbiota transplantation (FMT) remains an option for patients with refractory colitis. We report a multi-omics profiling of patients receiving first-line FMT for IMDC. In our preliminary analysis, 10 (76.9%) patients achieve clinical response, with a median time to clinical improvement of 1.5 (1–10.5) days. Among responder patients with baseline and follow-up samples, 6 (75%) show an increase in alpha-diversity post-FMT. Pre-FMT samples show an increase in the abundance scores of plasma cells, neutrophils, macrophages (M1 and M2), memory activated and resting memory CD4+ T cells, CD8+ T cells, T follicular helper (Tfh) cells, and regulatory T cells (Tregs), all of which decrease post-FMT. In a small cohort of patients, we identify potential mechanisms for FMT response and demonstrate that first-line FMT in patients with IMDC (NCT04038619) can be effective.
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BibTeX
@article{wang2026firstline,
title = {{First-line fecal microbiota transplantation for the management of immune checkpoint inhibitor-mediated diarrhea and colitis}},
author = {Yinghong Wang and Christopher Fan and Krishnavathana Varatharajalu and Malek Shatila and Carolina Colli Cruz and Baohua Sun and Nejla Ozirmak Lermi and Tomo Hayase and Anusha Thomas and Klaudia Anna Szymonowicz and Beatriz Sanchez Espiridion and Dzifa Yawa Duose and Eiko Hayase and Lin Tan and Yiwei Liu and Chia-Chi Chang and Cesar A. Arias and Kristin Junek and Herbert L. DuPont and Zhi-Dong Jiang and Sang T. Kim and Roza Nurieva and Matthew T. Campbell and Nizar M. Tannir and Jianjun Gao and Stephanie S. Watowich and Xin Shelley Wang and Ken Chen and Philip L. Lorenzi and Cara Haymaker and Edwin Roger Parra and Robert R. Jenq},
journal = {Cell Reports Medicine},
year = {2026},
month = sep,
doi = {10.1016/j.xcrm.2026.103044},
url = {https://doi.org/10.1016/j.xcrm.2026.103044},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - First-line fecal microbiota transplantation for the management of immune checkpoint inhibitor-mediated diarrhea and colitis
AU - Yinghong Wang
AU - Christopher Fan
AU - Krishnavathana Varatharajalu
AU - Malek Shatila
AU - Carolina Colli Cruz
AU - Baohua Sun
AU - Nejla Ozirmak Lermi
AU - Tomo Hayase
AU - Anusha Thomas
AU - Klaudia Anna Szymonowicz
AU - Beatriz Sanchez Espiridion
AU - Dzifa Yawa Duose
AU - Eiko Hayase
AU - Lin Tan
AU - Yiwei Liu
AU - Chia-Chi Chang
AU - Cesar A. Arias
AU - Kristin Junek
AU - Herbert L. DuPont
AU - Zhi-Dong Jiang
AU - Sang T. Kim
AU - Roza Nurieva
AU - Matthew T. Campbell
AU - Nizar M. Tannir
AU - Jianjun Gao
AU - Stephanie S. Watowich
AU - Xin Shelley Wang
AU - Ken Chen
AU - Philip L. Lorenzi
AU - Cara Haymaker
AU - Edwin Roger Parra
AU - Robert R. Jenq
PY - 2026
DA - 2026/09/14
JO - Cell Reports Medicine
DO - 10.1016/j.xcrm.2026.103044
UR - https://doi.org/10.1016/j.xcrm.2026.103044
AB - Immune checkpoint inhibitor (ICI) therapy commonly leads to adverse events such as ICI-mediated diarrhea and colitis (IMDC). Fecal microbiota transplantation (FMT) remains an option for patients with refractory colitis. We report a multi-omics profiling of patients receiving first-line FMT for IMDC. In our preliminary analysis, 10 (76.9%) patients achieve clinical response, with a median time to clinical improvement of 1.5 (1–10.5) days. Among responder patients with baseline and follow-up samples, 6 (75%) show an increase in alpha-diversity post-FMT. Pre-FMT samples show an increase in the abundance scores of plasma cells, neutrophils, macrophages (M1 and M2), memory activated and resting memory CD4+ T cells, CD8+ T cells, T follicular helper (Tfh) cells, and regulatory T cells (Tregs), all of which decrease post-FMT. In a small cohort of patients, we identify potential mechanisms for FMT response and demonstrate that first-line FMT in patients with IMDC (NCT04038619) can be effective.
SN - 2666-3791
ER -