Work

Nutritional regulation of the tumor immune microenvironment: metabolic mechanisms, immunotherapy response, and nursing implications

Year: 2026

Type: review

Abstract: Nutrition is increasingly recognized as an active regulator of the tumor immune microenvironment rather than a passive supportive-care factor. Beyond maintaining body weight and treatment tolerance, dietary inputs and nutritional interventions can reshape systemic metabolism, gut microbial ecology, stromal barriers, immune-cell fitness, and response to immune checkpoint blockade. Recent experimental and translational studies indicate that fasting-mimicking diets, ketogenic interventions, carbohydrate-derived signals, amino acid availability, lipid mediators, artificial sweeteners, and microbiota-derived metabolites may either enhance or impair antitumor immunity depending on tumor type, host metabolic status, microbial composition, and treatment context. These effects involve multiple interconnected mechanisms, including CD8 + T-cell activation or exhaustion, myeloid-cell reprogramming, cancer-associated fibroblast-mediated immune exclusion, adipocyte and hepatocyte metabolic signaling, and microbiome-dependent immune modulation. Importantly, the same nutritional factor may produce beneficial, neutral, or harmful effects across different models, indicating that nutrition should not be translated into universal anticancer dietary prescriptions. This review summarizes current evidence linking nutritional regulation to tumor immune remodeling and immunotherapy response, with particular attention to nursing implications. Oncology nurses play a key role in nutritional screening, patient education, monitoring of extreme dietary practices, assessment of supplement and artificial sweetener use, and multidisciplinary nutritional management during immunotherapy.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1938564

Authors: Danwei Zhong, Congjue Li, Zunyao Xiao

Institutions: Dalian Medical University, Second Affiliated Hospital of Dalian Medical University

Language: English

Topic: Cancer Immunotherapy and Biomarkers

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801