Department of Medical Oncology, Montpellier Cancer Institute (ICM), 34090, Montpellier, France.
Department of Radiotherapy, Montpellier Cancer Institute, 34090, Montpellier, France.
Support Care Cancer. 2024 Jun 22;32(7):452. doi: 10.1007/s00520-024-08661-6.
Supportive care has become a new pilar of modern oncology, and a great deal of research is being conducted in that area, especially on immune checkpoint inhibitors (ICIs), to help fine-tune immunotherapy. Four major areas of supportive care can enhance responsiveness to cancer immunotherapy whilst minimizing adverse effects: diet (indirectly, by modulating the microbiota or directly, by modulating the immune system), physical activity (by modulating the immune system), electronic patient-reported outcomes (ePRO) (by detecting and treating immune-related adverse events early on), and co-medication management (to possibly suppress those drugs that negatively affect the efficacy of ICIs). Therefore, patients treated with ICIs could receive a systematic multimodal supportive care program encompassing regular nutritional counseling, regular physical activity under the supervision of a physical activity professional, ePRO follow-up, and regular pharmaceutical counseling. This type of approach needs to be evaluated in well-conducted randomized clinical trials.
支持性治疗已成为现代肿瘤学的新支柱，该领域正在进行大量研究，特别是在免疫检查点抑制剂（ICI）方面，以帮助微调免疫疗法。支持性治疗的四个主要领域可以增强对癌症免疫疗法的反应，同时最大限度地减少不良反应：饮食（通过调节微生物群间接作用，或直接通过调节免疫系统）、身体活动（通过调节免疫系统）、电子患者报告结局（ePRO）（通过早期发现和治疗免疫相关不良事件）以及合并用药管理（可能抑制那些会降低 ICI 疗效的药物）。因此，接受 ICI 治疗的患者可以接受系统的多模式支持性治疗方案，包括定期营养咨询、在专业体育活动人员的监督下进行定期体育活动、ePRO 随访以及定期药物咨询。这种方法需要在精心设计的随机临床试验中进行评估。
