Gut bacteria could help revive immunotherapy in lung cancer
NCT ID NCT06448572
First seen Jun 24, 2026 · Last updated Jun 27, 2026 · Updated 1 time
Summary
This early-phase trial tests whether a capsule containing a healthy gut bacterium (EXL01) can boost the effectiveness of the immunotherapy drug nivolumab in people with advanced non-small cell lung cancer that has stopped responding to prior immunotherapy. The study will enroll 21 adults whose cancer has progressed after standard treatments. Researchers will monitor how long the cancer stays under control and track any side effects.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- EXL01 (a single strain of the gut bacterium Faecalibacterium prausnitzii) combined with nivolumab
- What this could lead to
- If it works, this could point toward a new treatment option for people with advanced lung cancer whose disease has stopped responding to standard immunotherapy.
- What could go wrong
- This is a very early, small pilot study with only 21 participants, so results may not apply to everyone. The combination may not improve outcomes and could cause side effects.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 1/2
Runs two stages together: safety and dose first, then whether the treatment works.
- Participants
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About 21 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Jul 2024
- Expected to finish
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Oct 2028
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Key inclusion Criteria: 1. Patients (male or female) ≥18 years old. 2. ECOG Performance status (PS) 0-1 (WHO). 3. Histologically or cytologically documented inoperable advanced/metastatic NSCLC. (inoperable stage III not amenable to radiation therapy or surgery, stage IV) 4. No alterations of key driver oncogenes including EGFR (mutations), ALK (fusions), ROS1 (fusions), MET (METex14 mutations), HER2 (exon 20 insertions), RET (fusions), or BRAF (V600E mutations). KRAS mutations are allowed. 5. Must have previously received anti-PD(L)1 agent and platinum-based chemotherapy, either concomitantly or sequentially. Last dose to have been administered more than 15 days prior to first dose of study drug. 6. Must have progressed within 6 months after first dose of anti-PD(L)1 given either alone or in combination with platinum-based chemotherapy. 7. Must have received all validated available standard therapies. 8. Measurable disease according to iRECIST 1.1. 9. Adequate hematological, renal and liver functions within 72 hours before the first dose of study treatment: * Absolute Neutrophil Count ≥ 1500/μL * Platelets ≥ 100 000/μL * Hemoglobin ≥ 9.0 g/dL * Creatinine Clearance ≥ 50 mL/min * Total Bilirubin ≤ 1.5 x ULN * AST and ALT ≤ 2.5 x ULN (≤ 5 x ULN for participants with liver metastasis) Key exclusion Criteria: 1. Small cell lung cancer or tumors with mixed histology including a SCLC component. 2. Known symptomatic CNS metastases and/or carcinomatous meningitis. Participants with asymptomatic brain metastases (ie, no neurological symptoms and no requirements for corticosteroids \> 10mg/d prednisone equivalent) may participate. 3. Diagnosis of immunodeficiency of is receiving systemic treatment with corticosteroids with greater dose than 10 mg prednisone equivalent daily, within 14 days before initiation of the immunotherapy induction. Inhaled, nasal or topic corticosteroids are allowed. 4. Living attenuated vaccine received within the 30 previous days. 5. Has received Fecal Microbiota Transplantation within 3 months prior to Screening. 6. General serious condition such as uncontrolled congestive cardiac failure, uncontrolled cardiac arrythmia, uncontrolled ischemic cardiac disease (unstable angina or history of myocardial infarction within the previous 6 months), history or stroke within the 6 previous months. 7. History of severe immune-mediated toxicity (≥ grade 3) under immunotherapy treatment. 8. History of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
1 site. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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CHU Lille
RECRUITINGLille, 59000, France
More trials for these conditions
Other studies related to the condition(s) this trial covers.
- Two-Drug combo targets stubborn KRAS lung cancer
- Smaller chest drain may speed recovery after lung cancer surgery
- Gut bacteria may hold clues to why some cancer treatments work better
- Breath-Tracking sensor aims to sharpen lung cancer scans
- Can PET scan signals predict who beats lung cancer with immunotherapy?
- Two-Drug combo takes aim at Hard-to-Treat lung cancer