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Review
. 2020 May 4;12(5):1153.
doi: 10.3390/cancers12051153.

Metabolism and Immune Modulation in Patients with Solid Tumors: Systematic Review of Preclinical and Clinical Evidence

Aurora Mirabile  1 , Licia Rivoltini  2 , Elena Daveri  2 , Claudio Vernieri  3   4 , Roberto Mele  5 , Luca Porcu  6 , Chiara Lazzari  1 , Alessandra Bulotta  1 , Maria Grazia Viganò  1 , Stefano Cascinu  1 , Vanesa Gregorc  1
Affiliations
Review

Metabolism and Immune Modulation in Patients with Solid Tumors: Systematic Review of Preclinical and Clinical Evidence

Aurora Mirabile et al. Cancers (Basel). .

Abstract

Several immunotherapy agents are the standard of care of many solid malignancies. Nevertheless, the majority of patients do not benefit from the currently available immunotherapies. It is therefore of paramount importance to identify the prognostic and predictive factors of tumor response/resistance and to design effective therapeutic strategies to overcome primary resistance and improve the efficacy of immunotherapy. The aim of this review is to underline the influence of the tumor and host metabolism on the antitumor immune response and to discuss possible strategies to improve the efficacy of available treatments by targeting the specific metabolic pathways in tumors or immune cells and by modifying patients' nutritional statuses. A systematic search of the Medline and EMBASE databases was carried out to identify scientific papers published until February 2020, which reported original research articles on the influence of tumor or host metabolism on antitumor immune response. The literature data showed the key role of glycolysis and mitochondrial oxidative phosphorylation, arginine, tryptophan, glutamine, lipid metabolism and microbiome on immune cell function. Moreover, specific nutritional behaviors, such as a low dietary intake of vitamin C, low glycemic index and alpha-linolenic acid, eicosapentenoic acid, docosahexaenoic acid, ornithine ketoglutarate, tryptophan and probiotic supplementation were associated with the potential clinical benefits from the currently available immunotherapies.

Keywords: cancer metabolism; immune response; immune-nutrition; immunotherapy; nutrition.

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Conflict of interest statement

The authors disclose no conflicts of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram on selection of preclinical and clinical articles.
Figure 2
Figure 2
Clinical ongoing approaches based on metabolic modulation as a strategy to improve the response to immune checkpoint inhibitors (ICI).
See this image and copyright information in PMC

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