Ketogenic dietary interventions (KDIs) are increasingly explored as adjuncts in oncology due to their metabolic and immunomodulatory effects. One mechanism by which KDIs are expected to modulate the immune system is by altering the gut microbiome, which has been shown to affect treatment outcomes, particularly in the context of immunotherapies. This review synthesized findings from 43 clinical trials to evaluate the current landscape of KDIs in cancer care, with a focus on the gut microbiota and immunotherapy. Although 47% of identified trials are completed, none have yet published results combining KDIs with immunotherapy. Since 2020, however, there has been a significant increase in ongoing studies investigating this combination and incorporating microbiome endpoints. While KDIs may help shape an immunotherapy-permissive environment, further clinical evaluation is necessary to determine the full extent of KDIs on the microbiome. Future research should prioritize longitudinal microbiome profiling and standardized adherence reporting to clarify the therapeutic potential of KDIs as a metabolic adjuvant to immune checkpoint inhibitors.

Immunotherapy has recently garnered more attention in the treatment of breast cancer. Ginseng has been extensively utilized in immunomodulation. Acupuncture is acknowledged as an effective adjunctive therapy for treating various cancers through the modulation of the immune system. Nonetheless, the extent to which the combination of ginseng and acupuncture exerts an enhanced anti-tumor effect in breast cancer treatment remains unclear. This study assessed the impact of mountain-cultivated ginseng in conjunction with acupuncture on the anti-tumor immune response in breast cancer in a 4T1 xenograft BALB/c mouse model. The findings indicated acupuncture, when paired with mountain-cultivated ginseng, could augment the suppression of tumor growth. Acupuncture in conjunction with ginseng therapy enhanced the immunological activity of CD8+ cytotoxic T cells by elevating the numbers of IFN-γ+/CD8+ T cells and TNF-α+/CD8+ T cells, along with the release of many pro-inflammatory cytokines (IL-2, IL-6, TNF-α, and IFN-γ). Furthermore, it was established that acupuncture in conjunction with ginseng therapy facilitated the degradation of PD-L1 and PD-1 via the Sirt1/AMPK-mediated autophagy pathway. This study revealed that the combination of acupuncture and ginseng treatment augmented the suppression of PD-1/PD-L1 immune checkpoint, hence amplifying the anti-tumor immune response and offering a potential method for breast cancer therapy.

Adipose tissue radiodensity has emerged as a prognostic biomarker in oncology. This study aimed to assess its prognostic value in colorectal cancer (CRC) patients receiving adjuvant therapy. Body composition was quantified by computed tomography, with visceral (VATd) and subcutaneous (SATd) adipose tissue radiodensity measured in Hounsfield units and categorized into tertiles, where higher tertiles indicated lower fat proportion, whereas lower tertiles higher fat proportion. The primary endpoint was 5-year overall survival. Stage III disease (HR 5.54, 95% CI: 1.64–18.70), recurrence or metastasis (HR 4.16, 95% CI: 2.39–7.24), and elevated systemic inflammation response index (HR 2.42, 95% CI: 1.55–3.76) were associated with reduced survival. Conversely, the second VATd tertile (HR 0.56, 95% CI: 0.33–0.94), adjuvant chemotherapy (HR 0.43, 95% CI: 0.22–0.84), and chemoradiotherapy (HR:0.45, 95% CI: 0.21–0.93) independently predicted improved outcomes. Higher tertiles of SATd and VATd negatively impacted the beneficial prognosis of adjuvant therapy. However, patients with intermediate SATd experienced better protective effects from chemotherapy or chemoradiotherapy (HR 0.17, 95% CI: 0.06–0.49; HR 0.26, 95% CI: 0.08–0.85, respectively). These findings indicate that intermediate VATd confers survival advantage, while elevated SATd may attenuate treatment efficacy, reinforcing adipose radiodensity as a clinically relevant prognostic marker in CRC.

We read with great interest the prospective multicenter study by Teng et al., which evaluated whether ultrasound-derived skeletal muscle indices could predict severe chemotherapy-related toxicity in patients with non-small cell lung cancer (NSCLC). We sincerely commend the authors for their innovative focus on a pragmatic, radiation-free tool that can be incorporated conveniently into routine oncology workflows. Their results—demonstrating that quadriceps cross-sectional area and muscle thickness independently predict grade 3–4 toxicities—offer clinically meaningful implications for early risk identification.

Foods that are industrially created and/or heavily manipulated in the manufacturing process are conceptualized as ultra processed foods (UPFs), reflecting an emerging dietary target for chronic disease prevention. This scoping review provides updated evidence on associations between UPF consumption and cancer risk and identifies potential carcinogenic properties within UPFs, highlighting implications for food policies, Registered Dietitian Nutritionists (RDNs) and other healthcare professionals. Using the PubMed and Scopus databases, a comprehensive search was conducted (2010–2025). Eligible articles were required to be peer reviewed, published in English, observational in design, utilize the NOVA classification system, and examine cancer incidence. A total of 23 articles were included, and 15 reported a positive association between UPF intake and cancer incidence. This appeared more pronounced when cancer was considered one of many chronic diseases, and factoring in subgroup analyses within larger populations. Sugar-sweetened beverages and ultra-processed meats were isolated UPFs associated with higher cancer risk, allowing RDNs and other healthcare practitioners tangible dietary targets to impact cancer risk. Given the collective evidence, significant investment is needed in methodologies to comprehensively and reliably classify UPFs and to integrate UPFs into public health nutrition campaigns, dietary guidelines and food labels promoting a better food environment for all.

Objective To evaluate the effects of whole-course immunonutrition management (WIM) on patients with stage III and IV nasopharyngeal carcinoma (NPC) undergoing radiotherapy. Methods A total of 103 patients with NPC admitted to our hospital between October 2021 and June 2023 were assigned to receive either conventional nursing (routine group, n = 51) or WIM therapy (experimental group, n = 52) according to different nursing methods. Outcome measures included nutritional status assessment, haematological indicators, adverse reactions and the social support situation. Results Following the intervention, the WIM approach was associated with a significantly lower incidence of adverse reactions compared with routine nursing care (p < 0.05). Specifically, the experimental group had a significantly lower incidence of nausea (p = 0.0341), vomiting (p = 0.0279) and high-level oral mucositis (III/IV) (p = 0.0238) compared with the routine group. In terms of the nutritional status, patients in the experimental group maintained better body mass index (BMI) and body weight, with significant differences observed in total protein levels (p < 0.05) throughout the trial, indicating improved nutritional outcomes. However, no significant differences were found in the changes of BMI between the two groups. The social support situation was also significantly better in the experimental group, as evidenced by a greater improvement in the social support rating scale scores (p = 0.0017). Conclusions Whole-course immunonutrition management can improve the nutritional status of patients with NPC treated with concurrent chemoradiotherapy, reduce the severity of radiation-induced nasopharyngeal and oral reactions and relieve side effects.

People living with and beyond cancer (LWBC) are advised to follow World Cancer Research Fund (WCRF) dietary guidelines. However, there is no established methodology to assess adherence. This study aimed to: (i) develop methodology to process dietary recalls into a format comparable to WCRF guidelines and (ii) evaluate the impact of additional data processing on estimates of dietary intake, in people LWBC. Advancing Survivorship Cancer Outcomes Trial (ASCOT) participants completed two 24-h dietary recalls at four timepoints using myfood24. Five WCRF recommendations (limiting consumption of energy dense foods, red meat and processed meat, and increasing consumption of fruit and vegetables and wholegrains and pulses) were operationalized (e.g. ≤ 500 g red meat per week). Quality control checks indicated the need for additional processing, including changing portion sizes and choosing alternative items from myfood24 to improve accuracy. Compared to myfood24 output, the processed dietary data indicated lower intake of fruit and vegetables, and higher intake of NSP and AOAC fiber (all ps < 0.001). Developing methodology to allow assessment of 24-h dietary recall data against WCRF guidelines was possible and necessary but resource intensive. Additional data processing impacted estimates of the key foods and nutrients consumed by trial participants in a meaningful way.

This study examines the effects of a dietary and physical activity intervention on body composition and metabolic parameters in Moroccan women with breast cancer. Conducted as a pilot cohort study, 37 women with breast cancer were recruited between 2017 and 2019 at the Hassan II Regional Hospital Center and the Agadir Regional Oncology Center. Participants completed a 12-month nutrition and physical activity intervention. The mean age was 47.92±8.56years. At the end of the intervention, participants experienced a mean weight loss of 11%, resulting in a significant reduction in normal weight and obesity rates from 35.14% and 32.43% to 57% and 5%, respectively (p<0.05). Waist and hip circumferences were reduced by 10%, and there were significant reductions in body fat and visceral fat. Improvements were also seen in metabolic markers, with significant reductions in total cholesterol, LDL-C, blood glucose and HbA1c levels (p<0.05). Lean mass was preserved and HDL-C showed a significant increase (p<0.001).

Background Whether preoperative sarcopenia predicts increased risk of anastomotic leakage in operated esophageal cancer patients remains unclear. This study aimed to identify the relationship between preoperative sarcopenia and the incidence of anastomotic leakage in surgical esophageal cancer. Methods PubMed, EMBASE, CNKI and Web of Science databases were searched up to October 11, 2024. Odds ratios (ORs) and 95% confidence intervals (CIs) were combined and subgroup analysis based on the pathological type, definition of sarcopenia and history of neoadjuvant therapy were performed. Results Fifteen studies with 3,785 patients were included and 368 patients developed the anastomotic leakage (9.72%). Pooled results demonstrated that preoperative sarcopenia was significantly associated with the occurrence of anastomotic leakage among surgical esophageal cancer patients (OR = 1.57, 95% CI: 1.29–1.90, p < 0.001). Subgroup analysis by the pathological type and definition of sarcopenia revealed similar results. However, subgroup analysis by the neoadjuvant therapy indicated that preoperative sarcopenia was only related to anastomotic leakage among patients without the history of neoadjuvant therapy (OR = 2.40. 95% CI: 1.61–3.58, p < 0.001), and sarcopenia was not a significant risk factor for anastomotic leakage in neoadjuvant therapy treated patients (OR = 1.06, p = 0.845). Conclusion Preoperative sarcopenia could serve as a risk indicator in surgical esophageal cancer patients without neoadjuvant therapy.