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Vol. 2 No. 2 (2025)

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October 18, 2025
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October 22, 2025

Copyright (c) 2025 Saad Laiban B Al Rowaili, Ali Saeed Al Alshiak, Abdullah Esse Al khamis, Adel Abdullah Al Shggag, Eman Ghannam Alotaibi, Maha Shreedah Alenazi, Dalal Mohmmed Al-Dosiry, Azhar Ali Albdiawy, Mohammed Ibrahim A Alrajal, Abdullatif Abdulrhman Alsaeed, Fatimah Saeed Alyagoub, Dhaha Hassan Al-Saffar

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The Interface of Nutrition and Immunity: An in-depth look at nutritional interventions for the oncology patient receiving immunotherapy

https://doi.org/10.64483/jmph-155
Saad Laiban B Al Rowaili
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health, Saudi Arabia
Ali Saeed Al Alshiak
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Abdullah Esse Al khamis
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Adel Abdullah Al Shggag
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Eman Ghannam Alotaibi
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Maha Shreedah Alenazi
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Dalal Mohmmed Al-Dosiry
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Azhar Ali Albdiawy
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Mohammed Ibrahim A Alrajal
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Abdullatif Abdulrhman Alsaeed
Eradah (Al Amal) Mental Health Complex, Dammam,Ministry of Health , Saudi Arabia
Fatimah Saeed Alyagoub
Maternity and Children Hospital, Saudi Arabia
Dhaha Hassan Al-Saffar
Al-Majidiyah Health Center in Qatif, Ministry of Health , Saudi Arabia

Corresponding Author(s) : Saad Laiban B Al Rowaili

salrowaili@moh.gov.sa

Saudi Journal of Medicine and Public Health, Vol. 2 No. 2 (2025)

Abstract

Background: Immunotherapy, as immune checkpoint inhibitors (ICIs), has revolutionized oncology by taking advantage of the patient's native immune system to combat cancer. Although responses are heterogeneous, immune-related adverse events (irAEs) can limit treatment benefit and decrease quality of life. A growing appreciation is arising that host factors, including nutritional status and diet, play an important role in determining the immune response and tumor microenvironment.


Aim: The objective of this review is to provide an overview of the current evidence relating to nutritional strategies in cancer immunotherapy patients. It considers the ruinous role of malnutrition (cachexia) in clinical outcomes, reviews the mechanisms by which particular dietary components influence anti-tumor immunity and treatment side effects, and provides a model for the practical assessment and management of nutritional deficits.


Methods: A systematic review of the literature was conducted through the utilization of leading scientific databases (e.g., PubMed, Scopus, Web of Science) to identify preclinical, clinical, and review articles published up to 2024. Search terms were permutations of "immunotherapy," "immune checkpoint inhibitors," "nutrition," "diet," "cachexia," "microbiome," and "immune-related adverse events." The evidence was synthesized to provide a narrative review of the existing literature.


Results: There is evidence that indicates that sarcopenia and malnutrition have a close correlation with poorer efficacy of ICI and increased toxicity. Individual nutritional interventions are promising for modulating outcomes: adequate consumption of good-quality protein is crucial for the avoidance of muscle wasting and immune function maintenance; dietary fiber and omega-3 fatty acids exert anti-inflammatory effects and preserve a healthy gut microbiome; the Mediterranean diet and vegetarian dietary patterns are related to improved survival; and micronutrients like Vitamin D have a role in immune regulation. The gut microbiome is identified as a mediator between diet and immunotherapy response.


Conclusion: An active, individualized nutrition approach, emphasizing a whole-food, plant-based diet, adequate protein, specific micronutrients, and gut microbiome support, is very promising as an adjunctive strategy to enhance the efficacy and tolerability of immunotherapy. Further robust, prospective clinical trials are needed to solidify specific recommendations and integrate nutritional therapy into the standard armamentarium of immuno-oncology treatment.

Keywords

Immunotherapy, Clinical Nutrition, Cancer Cachexia, Gut Microbiome, Immune-Related Adverse Events.
Al Rowaili, S. L. B., Alshiak, A. S. A., Al khamis, A. E., Al Shggag, A. A., Alotaibi, E. G., Alenazi, M. S., … Al-Saffar, D. H. (2025). The Interface of Nutrition and Immunity: An in-depth look at nutritional interventions for the oncology patient receiving immunotherapy. Saudi Journal of Medicine and Public Health, 2(2), 569–577. https://doi.org/10.64483/jmph-155
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