Cancer immunotherapy therapy and the Mediterranean diet

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Researchers report that a Mediterranean diet may help bolster treatments for people with melanoma. Drazen/Getty Images
  • Researchers say a Mediterranean diet boosted treatment for people with melanoma using immune checkpoint inhibitors.
  • They added that the diet high in fiber and polyphenols also reduced the risk of side effects from treatment.
  • Experts add that the Mediterranean diet is beneficial for the overall health of most people.

People who enjoy Greek cuisine and other Mediterranean dishes may be pleased to know that what you eat can prolong and even save your life.

A new study from the Netherlands and the UK has found that a Mediterranean diet can improve immunotherapeutic response in people with advanced melanoma, the most serious type of skin cancer.

The research was presented today at a conference held by the European Society for Gastrointestinal Endoscopy. The results have not yet been published in a peer-reviewed journal.

In their study, the researchers report that a Mediterranean diet high in fiber, monounsaturated fatty acids, and polyphenols was associated with better rates of immunotherapeutic response and progression-free survival in people with advanced melanoma.

Dr. Laura Boltea dietitian, doctoral candidate and study author, told Healthline that a Mediterranean diet containing mono and polyunsaturated fats from olive oil, nuts and fish as well as polyphenols and fiber from vegetables, fruits and whole grains, was associated with a significantly improved response to immunotherapy drugs called immune checkpoint inhibitors.

Inhibitors, which are among the most effective treatments for melanoma to date, work by blocking checkpoints in a person’s immune system, which then forces the body’s T cells to attack the cancers.

Researchers leading the multicenter study recorded the food intake of 91 people with advanced melanoma who were treated with immune checkpoint inhibitor drugs and monitored their progress through regular X-ray checks.

People in the study weren’t put on a specific diet, but they did fill out a detailed dietary questionnaire before treatment through which the researchers assessed their eating habits, Bolte said.

In addition to having a significant association with overall response rate, a Mediterranean diet was significantly associated with progression-free survival at 12 months, the researchers reported.

Immune checkpoint inhibitors have helped revolutionize the treatment of different types of advanced cancers and Bolte noted that this latest study underscores the importance of dietary assessment in people with cancer starting these types of treatment.

Researchers also found that eating whole grains and legumes reduced the likelihood of developing drug-induced immune system side effects, such as colitis.

In contrast, red and processed meat was associated with a higher likelihood of immune system-related side effects.

Experts expect diet to play a big role in the success of immunotherapy, and clinical trials are being expanded to study outcomes for different types of tumors, including digestive cancers, Bolte said.

The relationship between the response of immune checkpoint inhibitors to diet and the gut microbiome opens up a promising and exciting future for improving treatment responses.

“Clinical trials looking at the effect of a high fiber diet, a ketogenic diet and omega-3 supplementation are ongoing,” Bolte said.

She added that since immune checkpoint inhibitor therapy is being extended to a variety of tumor types, including digestive cancers, these studies could unlock treatment benefits for a large group of cancer patients in the future.

Sonya OrmeSan Diego business owner and life coach, born and raised in Istanbul, Turkey, told Healthline she was not surprised by the results of this study.

When she returns to Turkey to see her family, Orme said she obviously feels better. When she returns to the United States, she notices inflammation in her gut that is coming back to some extent and she thinks it is from the food.

Orme says eating olives, olive oil, fish, nuts, vegetables and fruits is healthy, as is adding lemon to the daily diet.

“When I go back to Turkey, as soon as I start eating, it makes a difference. I realized that this type of food is really good for inflammation, when I come back to the US my body feels more inflamed again,” she said.

When you eat fresh Mediterranean food, you can really feel the difference, Orme said.

“We don’t use the store-bought salad dressings in the US, for example, they’re not as healthy, and I also think the amount of vegetables eaten every day in Mediterranean homes makes a difference. We do not store food in cans. No processed foods,” she said.

Historically, nutrition has been somewhat neglected in prospective oncology studies.

“However, that is changing, and a number of studies examining nutrition as cancer therapy are underway around the world,” Bolte said.

She added that immune checkpoint inhibitors have improved the prognosis of several types of late-stage tumors.

However, not everyone with cancer responds to this treatment.

“Some patients develop immune-related side effects induced by the drugs, such as colitis, which is inflammation of the gut,” she said.

“So the question is, how can we increase the response to immune checkpoint inhibitors so that more patients benefit?” The relationship of immune checkpoint inhibitors to diet and the gut microbiome opens up a promising and exciting opportunity to do just that,” Bolte said.


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