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NCT Number: NCT06206707

FMT in Checkpoint Inhibitor-mediated Diarrhea and Colitis

The goal of this clinical trial is to determine the outcome of patients with immune checkpoint inhibitor-mediated diarrhea/colitis (IMC) treated with faecal microbiota transplantation (FMT) in a randomised, placebo-controlled trial.

The aim of the present study is to assess the feasibility, pilot efficacy, and safety of FMT for patients with IMC.

Participants will be treated two times with capsule FMT or placebo capsules in a 1:1 ratio. The intervention treatment will be an add-on to the patients' standard treatment for IMC.

Researchers will compare the FMT-treated group to the placebo-treated group to see if FMT promotes remission of IMC.

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Key information

About this study

As above

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 years or above.
  • Histologically proven diagnosis of malignant melanoma and/or kidney cancer.
  • Treatment with any immune checkpoint inhibitor (Nivolumab, Pembrolizumab, Cemiplimab, Atezolizumab, Durvalumab, Avelumab, Ipilimumab), alone or in combination, within the last 8 weeks.
  • Grade 2 or higher CTCAE diarrhea, of which at least 3 stools are Bristol chart score 6-7.
  • Negative PCR for enteric pathogens including C. difficile, after the onset of diarrhea.
  • Signed written informed consent.

Exclusion criteria

  • Diagnosed bacterial infection requiring antibiotic treatment at inclusion.
  • Pregnancy or breastfeeding. Pregnancy ruled out by male sex, postmenopausal women or a negative choriogonadotropin (hCG) urine test.
  • Primary diarrheal disease pre-existing to the immune checkpoint inhibitor treatment, including inflammatory bowel disease.
  • Unable to ingest capsules.
  • Unable to understand written or oral patient information.

Treatment and study plan

Faecal Microbiota Transplantation (FMT)

Procedure

Capsule FMT

Other names: Fecal Microbiota Transplantation, FMT

Placebo

Procedure

Placebo capsules

Primary outcomes

  1. Clinical remission of immune-mediated diarrhea

    Time frame: At 42 days after intervention treatment

    Number of patients with steroid-free resolution of diarrhea, defined as < 3 liquid stools (Bristol <6) per 24 hours during day 40 and 41 after the last intervention treatment.

Secondary outcomes

  1. Remission of diarrhea defined by CTCAE

    Time frame: At 42 days after intervention treatment

    Number of patients in steroid-free clinical remission of diarrhea 6 weeks (42 days) after the last intervention treatment. Clinical remission is defined as < 4 stools over baseline per day (CTCAE diarrhea grade 1 or less), at day 40 and 41.

  2. Remission of colitis defined by CTCAE

    Time frame: At 42 days after intervention treatment

    Number of patients in steroid-free clinical remission of colitis 6 weeks (42 days) after the last intervention treatment. Clinical remission is defined as asymptomatic in regards to colitis (CTCAE colitis grade 1 or less), at day 40 and 41.

  3. Therapy response of FMT

    Time frame: Up to 12 weeks after intervention treatment

    Therapy response defined as a decrease of at least 3 points in Simple Clinical Colitis Activity Index (SCCAI) score, at weeks 1, 6 and 12 after the last intervention treatment.

  4. Number of days until CTCAE diarrhea grade 1

    Time frame: Up to 12 weeks after intervention treatment

    Number of days until less than 4 stools over baseline per day (CTCAE diarrhea grade 1 or less), lasting a minimum of 48 consecutive hours with no increase in steroid dose in the 12 weeks of follow-up.

  5. Number of days until resolution of diarrhea

    Time frame: Up to 12 weeks after intervention treatment

    Number of days until resolution of diarrhea, defined as 3 or fewer Bristol type 6-7 stools per day, lasting a minimum of 48 consecutive hours.

  6. Incidence of fecal microbiota transplantation (FMT)-related adverse events

    Time frame: At 42 days after intervention treatment

    Number of adverse events (AE) during first 6 weeks after intervention treatment. AE's will be graded by CTCAE.

  7. Incidence of fecal microbiota transplantation (FMT)-related serious adverse events

    Time frame: At 12 weeks after intervention treatment

    Number of serious adverse events (SAE) during 12 weeks follow-up after the final intervention treatment. SAE's will be graded by CTCAE.

  8. Faecal microbiota composition

    Time frame: Up to 6 weeks after intervention treatment

    Changes in faecal microbiome composition from baseline to week 6 after the last intervention.

  9. Gut mucosa-associated microbiome

    Time frame: Up to 6 weeks after intervention treatment

    Changes in mucosa-associated microbiome from baseline to week 6 after the last intervention.

  10. Faecal-calprotectin

    Time frame: Up to 6 weeks after intervention treatment

    Percentual change in faecal-calprotectin from prior to intervention to week 6 after the last intervention.

  11. Blood immunological parameters

    Time frame: Up to 6 weeks after intervention treatment

    Changes in blood immunological parameters (including circulating cytokines) from baseline and at week 6 after the last intervention.

  12. Hospitalisation

    Time frame: Up to 12 weeks after intervention treatment

    Hospitalisation defined as the total number of days hospitalised, during 12 weeks of follow-up.

  13. Colectomy

    Time frame: Up to 12 weeks after intervention treatment

    Colectomy during 12 weeks of follow-up.

  14. Mortality

    Time frame: Up to 12 weeks after intervention treatment

    Mortality during the 12 weeks of follow-up.

  15. Accumulated steroid dose

    Time frame: Up to 12 weeks after intervention treatment

    Accumulated steroid dose (total dose in mg) during 12 weeks following experimental treatment.

  16. Resumption of immune checkpoint inhibitor therapy

    Time frame: Up to 12 weeks after intervention treatment

    Number of patients resuming immune checkpoint inhibitor therapy during the 12 weeks of follow-up.

  17. Response to immune checkpoint inhibitor therapy

    Time frame: Up to 12 weeks after intervention treatment

    Response to immune checkpoint inhibitor therapy defined by Response Evaluation Criteria in Solid Tumours (RECIST 1.1 and iRECIST).

  18. Patient and physician perceptions of FMT treatment

    Time frame: At 42 days after intervention treatment

    Patient and physician perceptions of FMT treatment and the usage for IMC assessed by a patient questionnaire at week 6 and a physician questionnaire.

  19. Health-related quality of life

    Time frame: At 42 days after intervention treatment

    Changes in health-related quality of life assessed by EQ-5D-5L at baseline and week 6.

  20. Endoscopic response

    Time frame: Up to 6 weeks after intervention treatment

    Endoscopic response, defined as decrease in Mayo endoscopic score ≥1 grade, at week 6 after the last intervention treatment.

  21. Endoscopic remission

    Time frame: Up to 6 weeks after intervention treatment

    Endoscopic remission, defined as Mayo endoscopic score 0, at week 6 after the last intervention treatment.

Study contacts

Contact information is provided by the study sponsor or research team.

Christian L Hvas, PhD

CONTACT

[email protected]

+4528351839

Trine L Laursen, BSc

CONTACT

[email protected]

+4540408207

Sponsors and collaborators

Lead sponsor

University of Aarhus

Other

Registry information

Official study title

Faecal Microbiota Transplantation for Immune Checkpoint Inhibitor-mediated Diarrhea/Colitis: a Randomised, Double-blind Pilot Efficacy and Safety Study

Acronym: Immunobiome

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Jan 16, 2024
Registry last updated
Nov 17, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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