Impact of Diets on Response to Immune Checkpoint Inhibitors (ICIs) Therapy against Tumors

Abstract

Immunotherapy has revolutionized the established therapeutics against tumors. As the major immunotherapy approach, immune checkpoint inhibitors (ICIs) achieved remarkable success in the treatment of malignancies. However, the clinical gains are far from universal and durable, because of the primary and secondary resistance of tumors to the therapy, or side effects induced by ICIs. There is an urgent need to find safe combinatorial strategies that enhance the response of ICIs for tumor treatment. Diets have an excellent safety profile and have been shown to play pleiotropic roles in tumor prevention, growth, invasion, and metastasis. Accumulating evidence suggests that dietary regimens bolster not only the tolerability but also the efficacy of tumor immunotherapy. In this review, we discussed the mechanisms by which tumor cells evade immune surveillance, focusing on describing the intrinsic and extrinsic mechanisms of resistance to ICIs. We also summarized the impacts of different diets and/or nutrients on the response to ICIs therapy. Combinatory treatments of ICIs therapy with optimized diet regimens own great potential to enhance the efficacy and durable response of ICIs against tumors, which should be routinely considered in clinical settings.

A Clinical Outcome of the Anti-PD-1 Therapy of Melanoma in Polish Patients Is Mediated by Population-Specific Gut Microbiome Composition

“…A recent study demonstrated that this link is cohort-dependent, and the presence or absence of a single species cannot serve as a predictive biomarker across various populations [ 7 ]. Moreover, several factors, such as diet or concomitant drugs [ 8 , 9 ], were associated with changes in the gut microbiota composition and immune system functions, and their role in ICI efficacy modulation has yet to be fully elucidated.…”

Pretreatment “prognostic nutritional index” as an indicator of outcome in lung cancer patients receiving ICI-based treatment: Systematic review and meta-analysis

“…In addition to regulating the function of immune cells through the regulation of metabolites such as amino acids, fatty acids and nucleotides in the body, diet can also influence the efficacy of ICIs by affecting the gut microecology. [41,43,63,64] Although our meta-analysis confirmed the PNI was a reliable prognostic indicator, clinicians should use caution when using a single indicator to predict patient prognosis. Because the clinical studies we examined have limitations, like all clinical studies, we suggest that future efforts consider development of an algorithm that considers the PNI along with several additional indicators, such as the neutrophil-to-lymphocyte ratio, red blood cell distribution width, platelet-to-lymphocyte ratio, lung immune prognostic index, and lactate dehydrogenase to more accurately assess patient prognosis.…”

“…In addition to regulating the function of immune cells through the regulation of metabolites such as amino acids, fatty acids and nucleotides in the body, diet can also influence the efficacy of ICIs by affecting the gut microecology. [ 41 , 43 , 63 , 64 ]…”

Effects of dietary intervention on human diseases: molecular mechanisms and therapeutic potential

“…A KD comprises a high-fat component, very low carbohydrate levels, and low to moderate protein levels, as explained in a recent study. 140 A traditional KD is typically formulated at a 4:1 ratio of fat:carbohydrate plus protein. 141 In this classical formulation, 80–85% of calories are derived from fat, 10–15% from protein, and less than 5% from carbohydrates.…”