4.6 Review

Dietary interventions and precision nutrition in cancer therapy

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Methionine deficiency facilitates antitumour immunity by altering m6A methylation of immune checkpoint transcripts

Ting Li et al.

Summary: Methionine and YTHDF1 play a critical role in anticancer immunity through regulating the functions of T cells. Targeting methionine metabolism or YTHDF1 could be a potential new strategy for cancer immunotherapy.
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Microbiota-derived 3-IAA influences chemotherapy efficacy in pancreatic cancer

Joseph Tintelnot et al.

Summary: Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer with limited response to chemotherapy. Researchers have found that the microbiota-derived metabolite, indole-3-acetic acid (3-IAA), is enriched in patients who respond to treatment. Using a combination of 3-IAA and chemotherapy can improve the efficacy of treatment, providing motivation for considering nutritional interventions in cancer patients.

NATURE (2023)

Article Endocrinology & Metabolism

The antitumour effects of caloric restriction are mediated by the gut microbiome

Yu-Qin Mao et al.

Summary: The study reveals that caloric restriction increases the presence of Bifidobacterium bifidum in the intestine, which ultimately inhibits tumor development in mice. Caloric restriction and intermittent fasting, without causing malnutrition, have been found to reduce the risk of cancer. Additionally, both caloric restriction and intermittent fasting can alter the composition of the gut microbiota. It is shown in this study that caloric restriction, but not intermittent fasting, protects against subcutaneous MC38 tumor formation in female mice through a mechanism involving the gut microbiota. These findings highlight the oncological significance of modulating the gut taxonomic composition in tumor growth and cancer immunosurveillance.

NATURE METABOLISM (2023)

Review Immunology

Control of immunity via nutritional interventions

Nicholas Collins et al.

Summary: Nutrition plays a profound role in shaping the immune system, with mild reductions in dietary intake enhancing protective immunity and limiting aberrant inflammatory responses. In severe nutritional stress, specific immunological functions are heightened to prioritize survival.

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Article Gastroenterology & Hepatology

Histone acetylation of bile acid transporter genes plays a critical role in cirrhosis

Amanda Garrido et al.

Summary: This study reveals the critical role of MCRS1 in the pathogenesis of cirrhosis, shedding light on potential new treatment strategies for the disease.

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Article Oncology

Fasting- Mimicking Diet Is Safe and Reshapes Metabolism and Antitumor Immunity in Patients with Cancer

Claudio Vernieri et al.

Summary: Cyclic fasting or fasting-mimicking diets (FMD) enhance antineoplastic treatments by modulating systemic metabolism and boosting antitumor immunity. In a clinical trial, the five-day FMD was found to be safe and resulted in consistent decrease of blood glucose and growth factor concentration, recapitulating metabolic changes observed in preclinical experiments. The FMD also reshapes anticancer immunity and improves clinical outcomes in patients with cancer.

CANCER DISCOVERY (2022)

Article Nutrition & Dietetics

Short-term fasting in glioma patients: analysis of diet diaries and metabolic parameters of the ERGO2 trial

Martin Voss et al.

Summary: The prospective ERGO2 trial investigated the effects of calorie-restricted ketogenic diet and intermittent fasting on re-irradiation for recurrent brain tumors, showing that the ketogenic diet did not improve progression-free survival. Unexpectedly, the control group had lower calorie intake than expected, while the ketogenic diet group met the preset goals for calorie and carbohydrate restriction.

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Article Oncology

Ketogenesis Attenuates KLF5-Dependent Production of CXCL12 to Overcome the Immunosuppressive Tumor Microenvironment in Colorectal Cancer

Ruozheng Wei et al.

Summary: This study identifies ketogenesis as a critical regulator of the tumor microenvironment in colorectal cancer and suggests the potential for ketogenic diets as a metabolic strategy to overcome immunosuppression and prolong survival.

CANCER RESEARCH (2022)

Article Multidisciplinary Sciences

β-Hydroxybutyrate suppresses colorectal cancer

Oxana Dmitrieva-Posocco et al.

Summary: The study identifies a metabolite signalling pathway that can be used as a strategy for preventing and treating colorectal cancer. Ketogenic diets and the ketone body BHB show a strong inhibitory effect on tumor growth by reducing cell proliferation. The findings suggest that BHB-triggered pathway could play a crucial role in regulating intestinal tumorigenesis.

NATURE (2022)

Article Biochemistry & Molecular Biology

Intestinal microbiota signatures of clinical response and immune-related adverse events in melanoma patients treated with anti-PD-1

John A. McCulloch et al.

Summary: An integrated analysis of microbiome and host cell transcriptional data in patients with melanoma treated with anti-PD-1 therapy reveals new associations between streptococcus species and immune-related adverse effects. The study also identifies consistent microbiome associations with clinical outcomes. The results show that baseline microbiota composition is optimally associated with clinical outcome one year after treatment initiation. Meta-analysis and bioinformatic analyses reveal that bacteria associated with favorable response are within the Actinobacteria phylum and Lachnospiraceae/Ruminococcaceae families of Firmicutes. Gram-negative bacteria, on the other hand, are associated with an inflammatory host intestinal gene signature and unfavorable outcome. Two different microbial signatures, enriched for Lachnospiraceae spp. and Streptococcaceae spp., are associated with favorable and unfavorable clinical response, respectively, along with distinct immune-related adverse effects. Supervised learning algorithms consistently predict treatment outcomes in all cohorts, despite heterogeneity between cohorts. The study provides valuable insights into the complex interaction between gut microbiome and response to cancer immunotherapy, paving the way for future research.

NATURE MEDICINE (2022)

Article Multidisciplinary Sciences

Impaired ketogenesis ties metabolism to T cell dysfunction in COVID-19

Fotios Karagiannis et al.

Summary: This study found that impaired production of beta-hydroxybutyrate (BHB) is associated with severe COVID-19 respiratory distress syndrome. BHB promotes the survival and interferon-gamma production of CD4(+) T cells. BHB acts as an alternative carbon source, fueling oxidative phosphorylation and maintaining the redox balance.

NATURE (2022)

Article Nutrition & Dietetics

Dietary Protein Restriction Improves Metabolic Dysfunction in Patients with Metabolic Syndrome in a Randomized, Controlled Trial

Rafael Ferraz-Bannitz et al.

Summary: This study aimed to investigate the benefits of dietary restriction in patients with metabolic syndrome and determine whether it is the calorie or protein restriction that mediates the effects. The findings showed that isocaloric dietary protein restriction can achieve similar clinical outcomes as calorie restriction, making it a more attractive and less drastic dietary strategy for patients with metabolic syndrome and has potential as an adjuvant therapy.

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Article Oncology

Exceptional tumour responses to fasting-mimicking diet combined with standard anticancer therapies: A sub- analysis of the NCT03340935 trial

Francesca Ligorio et al.

Summary: This study reports on several cases of advanced cancer patients achieving complete and long-lasting tumor remission through a combination of cyclic fasting-mimicking diets and standard anticancer therapies in the context of a clinical trial.

EUROPEAN JOURNAL OF CANCER (2022)

Review Oncology

Developing dietary interventions as therapy for cancer

Samuel R. Taylor et al.

Summary: This Review discusses metabolic alterations and vulnerabilities in different types of cancer, and suggests using dietary interventions in combination with pharmacologic therapies to target these changes. However, diet studies in cancer patients are rare and lack robust evidence. The article also explores how dietary strategies can be combined with pharmacological therapies in treating cancer.

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Article Oncology

Diet and cancer risk reduction: The role of diet-microbiota interactions and microbial metabolites

Tiffany L. Weir et al.

Summary: Cancer is a common disease, with complex interactions between diet, gut microbiota, and cancer risk. Lifestyle modifications, especially in diet, can prevent as much as 50% of cancer cases. Understanding the interplay between diet and gut microbiota helps clarify the impact of diet on cancer.

SEMINARS IN CANCER BIOLOGY (2021)

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Gut microbiota in human metabolic health and disease

Yong Fan et al.

Summary: The intestinal microbiota plays a significant role in human metabolic health, potentially contributing to the development of common metabolic disorders when dysregulated. Current research is shifting towards cause-and-effect studies and utilizing high-throughput human multi-omics data to identify potential molecular mechanisms behind these associations.

NATURE REVIEWS MICROBIOLOGY (2021)

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Fasting-mimicking diet blocks triple-negative breast cancer and cancer stem cell escape

Giulia Salvadori et al.

Summary: The study demonstrates that a fasting-mimicking diet activates starvation escape pathways in TNBC cells and reduces stemness markers in CSCs, leading to decreased cell numbers and improved mouse survival. Additionally, the diet activates different survival/growth pathways in differentiated cancer cells, which can be targeted by drugs to promote tumor regression.

CELL METABOLISM (2021)

Article Nutrition & Dietetics

Simple sugar intake and cancer incidence, cancer mortality and all- cause mortality: A cohort study from the PREDIMED trial

Juan C. Laguna et al.

Summary: This study found an association between intake of simple sugars in drinks and fruit juice and increased risk of overall cancer incidence and mortality, suggesting that sugary beverages may be a modifiable risk factor for cancer and all-cause mortality.

CLINICAL NUTRITION (2021)

Article Biochemistry & Molecular Biology

Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake

Kevin D. Hall et al.

Summary: In an inpatient, randomized controlled crossover trial, participants consumed 550-700 fewer calories per day when following a plant-based, low-fat diet with a high glycemic load compared with an animal-based, low-carbohydrate diet with a low glycemic load; weight loss was comparable between the two diets and there were no significant differences in hunger or enjoyment of the meals.

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Effect of Fasting-Mimicking Diet or Continuous Energy Restriction on Weight Loss, Body Composition, and Appetite-Regulating Hormones Among Metabolically Healthy Women with Obesity: a Randomized Controlled, Parallel Trial

Mehdi Sadeghian et al.

Summary: This study found that there was no significant difference in weight loss between FMD and CER. However, FMD was more effective at reducing insulin resistance, regulating appetite-regulating hormones, and preserving muscle mass and BMR.

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Ketogenic diet and ketone bodies enhance the anticancer effects of PD-1 blockade

Gladys Ferrere et al.

Summary: Limited experimental evidence suggests a link between nutrition and cancer immunosurveillance. This study demonstrates that ketogenic diet induces an anti-tumor effect through 3HB-mediated T cell-mediated cancer immunosurveillance. 3HB prevents immune checkpoint inhibition and promotes the expansion of specific T cells, while KD also leads to compositional changes in gut microbiota.

JCI INSIGHT (2021)

Article Multidisciplinary Sciences

Dietary palmitic acid promotes a prometastatic memory via Schwann cells

Gloria Pascual et al.

Summary: The study suggests that dietary palmitic acid (PA), but not oleic acid or linoleic acid, may promote metastasis in oral carcinomas and melanoma in mice. The PA-induced prometastatic memory requires the fatty acid transporter CD36 and is associated with stable deposition of histone H3 lysine 4 trimethylation by methyltransferase Set1A. Furthermore, the proregenerative state of tumor-activated Schwann cells induced by PA may play a role in long-term stimulation of metastasis.

NATURE (2021)

Article Multidisciplinary Sciences

Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response

Christine N. Spencer et al.

Summary: The study suggests that dietary fiber intake is associated with significantly improved progression-free survival in melanoma patients receiving ICB treatment, especially without the use of probiotics. Preclinical studies demonstrate that a low-fiber diet or probiotics can impair the treatment response to anti-PD-1 therapy, leading to a lower frequency of interferon-gamma-positive cytotoxic T cells in the tumor microenvironment.

SCIENCE (2021)

Article Multidisciplinary Sciences

Fecal microbiota transplant overcomes resistance to anti-PD-1 therapy in melanoma patients

Diwakar Davar et al.

Summary: The study demonstrated that fecal microbiota transplantation combined with anti-PD-1 therapy can overcome resistance to anti-PD-1 in a subset of PD-1 refractory melanoma patients, leading to clinical benefits. This approach induced changes in the gut microbiome and reprogrammed the tumor microenvironment, ultimately enhancing the efficacy of anti-PD-1 treatment.

SCIENCE (2021)

Review Nutrition & Dietetics

Vegan Diet Health Benefits in Metabolic Syndrome

Giulia Marrone et al.

Summary: A plant-based diet, particularly veganism, is becoming more popular for ethical, health, and environmental reasons. While a well-balanced vegan diet can promote optimal health, deficiencies in certain nutrients may occur if not properly managed. In addition, compared to omnivorous diets, vegan diets may reduce the risk of chronic diseases and have a lower environmental impact.

NUTRIENTS (2021)

Article Multidisciplinary Sciences

Daily caloric restriction limits tumor growth more effectively than caloric cycling regardless of dietary composition

Laura C. D. Pomatto-Watson et al.

Summary: Cancer incidence increases with age and is a leading cause of death. Caloric restriction (CR) confers benefits on health and survival and delays cancer. Alternative dietary interventions for cancer protection, such as plant-based diet mimicking fasting (FMD), are being explored, with results showing that daily CR provides greater protection against tumor growth and metastasis compared to periodic caloric cycling in a murine model of breast cancer.

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Cancer statistics for the year 2020: An overview

Jacques Ferlay et al.

Summary: The study briefly reviews the methods and data sources used in compiling the IARC GLOBOCAN cancer statistics for 2020 and summarizes the main results. It estimated that there were nearly 19.3 million new cancer cases and almost 10 million cancer deaths worldwide in 2020, with the most commonly diagnosed cancers being female breast cancer and lung cancer, and the most common causes of cancer death being lung cancer and liver cancer.

INTERNATIONAL JOURNAL OF CANCER (2021)

Review Oncology

Calorie Restriction for Cancer Prevention and Therapy: Mechanisms, Expectations, and Efficacy

Chiara Vidoni et al.

Summary: Cancer remains a significant health problem worldwide despite efforts to find new and more effective treatments. Calorie restriction, as well as caloric restriction mimetics, are being explored as potential interventions for preventing or slowing down cancer progression. Research shows that reducing calorie intake through dietary adjustments can impact tumor microenvironment and cancer metabolism, leading to reduced growth and progression of cancer.

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Selenium stimulates the antitumour immunity: Insights to future research

Ali Razaghi et al.

Summary: Selenium is a crucial trace element for regulating immune functions and plays important roles in cancer. At nutritional low doses, selenium acts as an antioxidant, while at supra-nutritional high doses, selenium induces redox signaling and cell death.

EUROPEAN JOURNAL OF CANCER (2021)

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Uptake of oxidized lipids by the scavenger receptor CD36 promotes lipid peroxidation and dysfunction in CD8+ T cells in tumors

Shihao Xu et al.

Summary: The accumulation of lipids in the tumor microenvironment is associated with dysfunction of CD8(+) T cells, mediated in part by the CD36 receptor and its promotion of lipid uptake and peroxidation. Inhibiting p38 kinase or resolving lipid peroxidation may restore effector T cell functions and provide a potential therapeutic avenue for immunotherapies.

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Safety and Feasibility of Fasting-Mimicking Diet and Effects on Nutritional Status and Circulating Metabolic and Inflammatory Factors in Cancer Patients Undergoing Active Treatment

Francesca Valdemarin et al.

Summary: Our study demonstrates that periodic cycles of a modified fasting regime are feasible and safe in cancer patients at low nutritional risk, without negatively affecting body composition. Additionally, this fasting regime can reduce fat mass, insulin production, and circulating IGF1 and leptin levels in cancer patients.

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Inhibition of the IL-17A axis in adipocytes suppresses diet-induced obesity and metabolic disorders in mice

Ana Teijeiro et al.

Summary: The study demonstrates that inhibiting the IL-17A axis can suppress diet-induced obesity and metabolic disorders, while promoting adipose tissue browning, thermogenesis, and energy expenditure. IL-17A also induces pathological changes in adipocytes, leading to obesity and metabolic syndrome.

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Cirrhosis: A Questioned Risk Factor for Hepatocellular Carcinoma

Amanda Garrido et al.

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Ketogenic diet in the treatment of cancer - Where do we stand?

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James L. Dorling et al.

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Prebiotic-Induced Anti-tumor Immunity Attenuates Tumor Growth

Yan Li et al.

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Mario Mehmel et al.

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Naama Kanarek et al.

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Peter Kaiser

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Fasting-mimicking diet and hormone therapy induce breast cancer regression

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Fasting protects mice from lethal DNA damage by promoting small intestinal epithelial stem cell survival

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Serine Deprivation Enhances Antineoplastic Activity of Biguanides

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Fasting Cycles Retard Growth of Tumors and Sensitize a Range of Cancer Cell Types to Chemotherapy

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Adipocytes promote ovarian cancer metastasis and provide energy for rapid tumor growth

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A high-fat, ketogenic diet induces a unique metabolic state in mice

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Caloric restriction and body weight independently affect longevity in Wistar rats

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