Nutritional strategies in supporting immune checkpoint inhibitor, PI3K inhibitor, and tyrosine kinase inhibitor cancer therapies

Author: mycolabadmin
12/3/2025
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Summary

This review examines how nutrition and food-based interventions can improve cancer treatment outcomes for patients receiving targeted cancer therapies. A Mediterranean-style diet with plenty of fiber (30-50g daily) appears beneficial for patients on immune checkpoint inhibitor therapies by promoting healthy gut bacteria that support immune function. The review also discusses promising research on fermented foods, specific bacterial supplements, mushroom extracts, and fasting approaches as complementary strategies to enhance cancer treatment effectiveness while reducing side effects.

Background

Nutritional status of cancer patients undergoing targeted therapies including immune checkpoint inhibitors (ICIs), PI3K inhibitors, and EGFR-tyrosine kinase inhibitors (TKIs) significantly influences treatment outcomes and survival. These targeted therapies are bidirectionally influenced by and influence patients’ nutritional and metabolic status. Precision nutrition approaches offer an important avenue to optimize clinical outcomes as part of precision integrative oncology care.

Objective

This narrative review aims to comprehensively evaluate key nutritional strategies and natural product interventions supporting targeted cancer therapies, with sequential focus on ICIs, PI3K inhibitors, and EGFR-TKIs. The review examines how precision nutrition approaches can minimize toxicities, reduce treatment resistance, and encourage therapeutic synergies in cancer care.

Results

Mediterranean diet and high fiber intake (30-50g daily) show positive associations with improved progression-free survival and lower immunotherapy-related adverse events in ICI-treated patients. Multiple ongoing trials evaluate fermented foods, fasting regimens, ketogenic diet, and live bacterial products. Live biotherapeutic products including Clostridium butyricum CBM588, Akkermansia muciniphila strain P2261, and Faecalibacterium prausnitzii strain EXL01 show promising preliminary data. Mycotherapy and fucoidan have preclinical evidence supporting synergy with ICIs requiring human trial validation.

Conclusion

Rational individualized precision nutrition approaches based on detailed clinical assessment and validated biomarkers are essential to maximize targeted therapy effectiveness. Mediterranean-style diet with 30-50g fiber daily and microbiome-modulating interventions represent current evidence-based recommendations. Future clinical practice requires prospective validation of emerging dietary, prebiotic, and biotherapeutic strategies with baseline microbiome assessment to enable personalized optimization of cancer treatment outcomes.

Published in:Frontiers in Nutrition,
Study Type:Narrative Review,
Source: PMID: 41425618, PMCID: PMC12715609, DOI: 10.3389/fnut.2025.1670598