Mattavelli Elisa, Agustoni Francesco, Tartara Alice, De Simeis Francesca, Perrone Lorenzo, Caccialanza Riccardo, Pedrazzoli Paolo, Da Prat Valentina
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.
Front Immunol. 2025 Aug 25;16:1612567. doi: 10.3389/fimmu.2025.1612567. eCollection 2025.
In the last decades, immunotherapy has revolutionized cancer treatment. Despite its success, a significant number of patients fail to respond, and the underlying causes of ineffectiveness remain poorly understood. Factors such as nutritional status and body composition are emerging as key predictors of immunotherapy outcomes. In particular, poor nutritional status, sarcopenia, and low skeletal muscle mass are associated with poorer survival and immunotherapy response in several cancers. Conversely, certain parameters of body composition, such as adiposity, may have beneficial effects on immunotherapy efficacy. Nutritional status and body composition can be targeted through tailored nutritional support, making it a potential strategy to improve immunotherapy outcomes. Specific nutrients and modulation of the gut microbiota may further enhance immune functions, offering promising avenues for clinical improvement. Despite the promising potential of tailored nutritional support, clinical evidence remains limited, and further research is needed to establish optimal strategies to optimize immunotherapy response and effectiveness.
在过去几十年里，免疫疗法彻底改变了癌症治疗方式。尽管取得了成功，但仍有相当数量的患者没有反应，而治疗无效的根本原因仍知之甚少。营养状况和身体成分等因素正成为免疫疗法疗效的关键预测指标。特别是，营养状况差、肌肉减少症和骨骼肌质量低与多种癌症患者较差的生存率和免疫疗法反应相关。相反，身体成分的某些参数，如肥胖，可能对免疫疗法疗效有有益影响。营养状况和身体成分可以通过量身定制的营养支持来加以改善，这使其成为改善免疫疗法疗效的潜在策略。特定营养素和肠道微生物群的调节可能进一步增强免疫功能，为临床改善提供了有前景的途径。尽管量身定制的营养支持具有广阔前景，但临床证据仍然有限，需要进一步研究以确定优化免疫疗法反应和疗效的最佳策略。
