We know how the outcome of immunotherapies in cancer patients can be positively influenced by looking after the health of the gut microflora, upon which nutrition has a major impact (1).
Amongst other nutritional aspects, as a cancer nutrition expert I like to work with my clients on modulating their fibre intake, which has been shown to support this process. For example, in a recent study in the context of Immune checkpoint inhibitors (ICI) treatment for melanoma, ‘sufficient’ fibre intake from the diet (>20 grams a day, not too difficult to achieve) was associated with improved PFS (progression-free survival) compared with ‘insufficient’ intake (<20 grams a day) (2).
Also, consumption of a Mediterranean-style diet was associated with an increased likelihood of ICI response (3).
It is important to know that this type of results are from observational studies mainly (therefore limited by possible confounding factors), but evidence in this direction is growing (supported by in vivo, in vitro, and ‘omics’ analyses, too), pointing to the existence of a very crucial ‘diet-microbiota-immune axis’, where the breakdown of dietary fibre (and other prebiotic compounds from wholefood unprocessed diets) by our gut bacteria result in the production of compounds that have immunomodulatory effects.
The picture is far less straightforward when looking at the influence of probiotic (live bacteria) supplements on treatment outcomes, so I prefer to first of all work with (personalised) modulation of (prebiotic) fibre as one important dietary strategy for supporting healthy gut microbes, in combination with fermented foods where appropriate.
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