Mediterranean Diet and Its Role in Immunotherapy

The Mediterranean diet, containing mono- and polyunsaturated fats from olive oil, nuts, and fish, as well as polyphenols and fiber from vegetables, fruit, and whole grains, is rich in fiber, mono-unsaturated fatty acids, and polyphenols. It has been recommended for a number of medical conditions. Experts anticipate that the Mediterranean diet will play an important role in the success of immunotherapy, and trials are being expanded to investigate outcomes for different tumor types, including digestive cancers.

Study Findings

Researchers have found in a new study that Mediterranean diet intake improves immunotherapy response and progression-free survival in advanced melanoma. The study was presented at UEG Week 2022.

The study revealed that the Mediterranean diet was significantly associated with an improved response to immunotherapy drugs called Immune Checkpoint Inhibitors (ICIs). ICIs, which have been highly successful in treating melanoma, work by blocking immune system checkpoints, which then force the body's own T-cells to attack cancers.

The new multi-centre study by researchers from the UK and the Netherlands recorded the dietary intake of 91 patients with advanced melanoma, who were treated with ICI drugs and monitored their progress with regular radiographic response check-ups. As well as having a significant association with overall response rate, a Mediterranean diet was significantly associated with progression-free survival at 12 months.

Laura Bolte, author of the study and PhD candidate under the supervision of Prof. Rinse Weersma from the University Medical Center Groningen, Netherlands, commented, "ICI has helped to revolutionize the treatment of different types of advanced cancers. Our study underlines the importance of dietary assessment in cancer patients starting ICI treatment and supports a role for dietary strategies to improve patient outcomes and survival."

The study also found that eating whole grains and legumes reduced the likelihood of developing drug-induced immune-related side effects, such as colitis. In contrast, red and processed meat was associated with a higher probability of immune-related side effects.

"The relationship of ICI response with diet and the gut microbiome opens a promising and exciting future to enhance treatment responses. Clinical trials investigating the effect of a high fiber diet, ketogenic diet, and supplementation of omega-3 are underway. Since ICI therapy is being expanded to various tumor types, including digestive cancers, these studies could unlock treatment benefits for a large group of cancer patients in the future," added Laura Bolte.

References

• Bolte L, et al. Dietary Intake Influences the Response to Cancer Immunotherapy. Presented at UEG Week 2022; 9 October 2022; Vienna, Austria.
• National Cancer Institute. Immune Checkpoint Inhibitors. Available at: https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/checkpoint-inhibitors (Accessed: September 2022).