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We return to discuss stereotactic radiotherapy (SABR) in prostate cancer with the superb Dr Alison Tree from The Royal Marsden Hospital.

We discuss the findings of the TRAP study which extended time to next treatment by 6 months when SABR was used for sites of growing disease.

Do we always need to change systemic therapy when only one or two sites of metastatic disease is growing??

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We are back for part 2 to finish our journey through the Gut Microbiome with the excellent Professor Monty Pal !!

Few areas of cancer treatment have generated as much interest as the Gut Microbiome in recent years.

We discuss work done by Monty's team on CBM588 on immunotherapy in kidney cancer.

CBM 588 is a live bacterial product that is available in health shops in Japan where it is used to promote a healthy gut.

Monty's team found incredible results where it improved response rates for immunotherapy containing treatment and significantly improved time to tumour progression.

Plans are now afoot to trial this in a much larger phase 3 trial which could readout some exciting results!

We discuss;

- Should we run patient poo through an AI algorithm to see what gut microbiome changes are needed

- Can we engineer gut bacteria to make more of useful proteins in our gut

- Can we get more biotech companies to engage in this space to help move it forward at more pace

Of course Monty knocks it out of the park so he gets a Simply Oncology wish!!

Amazing to hear Professor Monty Pal share his thoughts on this exciting area of medicine.

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Did you know that we have more bacterial DNA than human DNA in our bodies. This is because our guts contain trillions of bacteria and are now being thought of as another organ of the body.

Join us this week as we discuss the Gut Microbiome (part 1 of 2) and its importance on drugs like immunotherapy response in cancer.

We talk to none other than the excellent Professor Monty Pal from The City of Hope Hospital in California.

Monty is an internationally respected kidney cancer expert and has been researching the impact of the gut microbiome on cancer outcomes in recent years.

We discuss;

The potential impact of fibre in our diet - any how much that looks like in Wheetabix.

The need for balanced good versus bad bacteria in our guts.

That probiotics are not recommended.

The challenges of a faecal microbiome transplant.

What a great episode!!