The Optimisticc team is supported through the Cancer Grand Challenges initiative. Learn more here

WP5: The interplay between the microbiota and colorectal cancer treatments

The colon is the most densely populated microbial ecosystem on the planet, containing several trillion microbial cells that produce 100-fold more gene products than our human cells do. Due to the presence of these microbial organisms, the colon has a finely tuned and specialized immune system that, regretfully, may also result in increased susceptibility to cancer development and resistance to immuno-oncology therapies. Moreover, increasing evidence suggests that the microbiome may influence the efficacy and toxicity of chemotherapy drugs, and may underlie the increasing rates of colorectal cancer seen in young people under the age of 50. 

Because disparate factors ranging from diet to lifestyle to medications to geography can shape an individual’s microbiome, we created a multi-center, international prospective cohort study called MICROCOSM (“Microbiome of Colorectal Cancer: Longitudinal Study of Mechanism”) to investigate how the microbiome impacts the efficacy and toxicity of cancer treatment, including immunotherapy and chemotherapy. Led by three leading academic centers (Dana-Farber Cancer Institute [Boston, MA], University of California, San Francisco, and Vall d’Hebron Institute of Oncology [Barcelona, Spain]), MICROCOSM will enroll 2,500 patients with colorectal cancer from multiple sites spanning several continents. Serial tumor, blood, and stool samples will be collected pre-, on-, and post-treatment from every patient for study of the interaction between treatment and the microbiome. Moreover, patients will complete a comprehensive and validated diet and lifestyle questionnaire once a year. The findings from MICROCOSM will lead to improved ability to select patients most likely to respond to immunotherapy and chemotherapy, decrease treatment-related side effects, and understand reasons why treatments do not or stop working. MICROCOSM will also characterize the microbiome in young-onset colorectal cancer to reveal insights into the underlying biological cause of young-onset colorectal cancer and evaluate if gut bacteria may be a factor in rising colorectal cancer incidence among younger adults.

Work Package Leaders

Kimmie Ng, MD, MPH

Kimmie Ng, MD, MPH

Co-Investigator, Dana-Farber Cancer Institute

  • Associate Professor of Medicine, Harvard Medical School
  • Director, Young-Onset Colorectal Cancer Center
  • Co-Director, Colon and Rectal Cancer Center
  • Director of Translational Research
  • Center for Gastrointestinal Oncology, Dana-Farber Cancer Institute
Josep Tabernero, MD, PhD

Josep Tabernero, MD, PhD

Co-Investigator, Vall d’Hebron Institute of Oncology

  • Director of Vall d’Hebron Institute of Oncology

  • Head of the Medical Oncology Department of Vall d’Hebron University Hospital

  • Director of Clinical Research at Vall d’Hebron Institute of Oncology

  • Co-Director of Research Unit for Molecular Therapy of Cancer-“la Caixa” at Vall d’Hebron Institute of Oncology

  • Head of the Gastrointestinal and Endocrine Tumors Group at Vall d’Hebron Institute of Oncology

  • Director of Innovation, Care and Research, Catalonian Oncology Network. Barcelona, Spain.

  • Professor, Medicine Department, Universitat de Vic, Universitat Central de Catalunya. Vic, Barcelona, Spain.

Candace Henley, CPN

Candace Henley, CPN

Patient Advocate

Candace is an accomplished Foundation Executive Director with significant experience in community outreach and patient education. Superior record of successful community service and engagement. Candace is a 14-year colon cancer survivor who works to help other cancer survivors make sense of the disease as well as publicly share her story of a challenging battle with a positive attitude and faith that inspires others to never give up. 

Meet Candace

Carlos Hue, PhD

Carlos Hue, PhD

Patient Advocate

He received a degree in Psychology and Pedagogy by Complutense University of Madrid and a doctorate in Education by the University of Barcelona. He worked in a public Social Service Institute as a psychologist from1976 to 1999. Since 2000, he has been working as an Advisor for long life learning education in the Ministry of Education of the regional Govern of Aragon. Simultaneously, he has been teaching Psychology and Education for teachers and professors at the University of Zaragoza, and many other Universities in Spain.

Meet Carlos

Learn about other Work Packages

WP1: The Microbiome in colorectal cancer risk

WP1: The Microbiome in colorectal cancer risk

WP1: The Microbiome in colorectal cancer riskWe are analyzing the microbiome of 3000 bowel tumors, to determine the relationship between the bacteria within tumors and their mutations. We have analyzed the microbiome of over 2288 bowel cancer screening samples. Our...

WP 2: Epidemiological correlates of the colorectal cancer microbiome

WP 2: Epidemiological correlates of the colorectal cancer microbiome

WP2: Epidemiological correlates of the colorectal cancer microbiomeColorectal cancer (CRC) most often occurs sporadically (as compared to genetic forms of the disease) and is one of the leading causes of cancer-related death worldwide. Environmental factors contribute...

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