Enterococcal autoprobiotics in the complex treatment of colorectal cancer patient receiving chemotherapy: Two case reports and review of literature

BACKGROUND According to the literature, significant disorders of gut microbiota are consistently observed in patients with colorectal cancer (CRC). Disorders of gut microbiota composition are manifesting clinically as abdominal pain, dyspeptic symptoms (such as rumbling, bloating, and altered bowel habits, including both constipation and diarrhea), and overall reduced quality of life. Also, negative changes in the microbiota may be associated with a more frequent development of postoperative complications and complications during chemotherapy. CASE SUMMARY Two patients with CRC underwent surgery (laparoscopic left hemicolectomy) and were prescribed chemotherapy regimen consisted of cisplatin, leucovorin, and fluorouracil. Along with prescribed chemotherapy patients took autoprobiotic enterococci. A fecal sample was collected for autoprobiotic preparation, ensuring that the patient had not taken antibiotics, probiotic supplements, or probiotic-containing foods for at least 10 days. An autoprobiotic contained an indigenous strain of Enterococcus faecium (E. faecium ) was formulated. The patients received the autoprobiotic strain E. faecium (liquid form with a concentration of 8 Lg CFU/mL) orally at a dose of 50 mL twice daily during 10 days, regardless of meal times, from the first day of cytostatic treatment, throughout the first course of chemotherapy. As a result, autoprobiotic intake improved patient well-being and prevent side effects associated with the use of cytostatics. CONCLUSION The use of autoprobiotics in the treatment of CRC is a promising area to reduce the risks of postoperative complications, increase the tolerability of the basic chemotherapeutic regimen, as well as improve the quality of life.