From the Guidelines
Dietary supplements with proven efficacy for a patient with squamous cell esophageal carcinoma treated with surgery and nivolumab immunotherapy are limited, but peri- or postoperative administration of specific formulas enriched with arginine, omega-3-fatty acids, and ribonucleotides may be beneficial in malnourished patients.
Key Findings
- The ESPEN practical guideline recommends the use of specific formulas enriched with arginine, omega-3-fatty acids, and ribonucleotides in malnourished patients undergoing major cancer surgery 1.
- A meta-analysis of six RCTs including 628 patients undergoing surgery for oesophagogastric cancer with enteral immunonutrition did not demonstrate consistency in clinical outcome parameters, but another meta-analysis found significant benefits with regard to postoperative complications 1.
- Regular assessments of nutritional intake and physical activity are required during anticancer drug treatment to prevent weight loss and decreases in muscle mass and function, and personalized dietetic counselling, associated with ONS if necessary, has been recommended in cases of overt malnutrition 1.
Recommended Supplements
- Arginine: an amino acid that may help improve immune function and reduce inflammation.
- Omega-3-fatty acids: may help reduce inflammation and improve immune function.
- Ribonucleotides: may help improve immune function and reduce inflammation.
Important Considerations
- These supplements should only be used in malnourished patients undergoing major cancer surgery.
- The evidence for the use of these supplements in patients with squamous cell esophageal carcinoma treated with surgery and nivolumab immunotherapy is limited, and more research is needed to fully understand their benefits and risks.
- Patients should consult with their healthcare provider before starting any dietary supplements, as they may interact with other medications or have adverse effects in certain individuals.
From the Research
Dietary Supplements for Squamous Cell Esophageal Carcinoma
- There is limited evidence on the efficacy of dietary supplements for patients with squamous cell esophageal carcinoma treated with surgery and nivolumab (Opdivo, nivolumab) immunotherapy 2, 3, 4.
- Nutritional supplementation has been shown to improve nutritional status, prevent malnutrition, and reduce complications in hospitalized patients, including those with cancer 5.
- However, the use of nutritional supplements in cancer patients is complex, and some supplements have been shown to have adverse effects, such as increasing the risk of certain cancers or reducing the effectiveness of cancer treatments 6.
Potential Benefits and Harms of Nutritional Supplements
- Some nutritional supplements, such as vitamin D and n-3 supplements, may have potential benefits for cancer patients, including reducing toxicity and improving outcomes 6.
- However, other supplements, such as beta-carotene and vitamin E, have been shown to increase the risk of certain cancers and reduce overall survival 6.
- The use of nutritional supplements in cancer patients should be individualized and based on credible evidence, with open dialogue between patients and clinicians 6.
Immunotherapy and Nutrition
- Immunotherapy, including nivolumab, has been shown to improve survival outcomes in patients with squamous cell esophageal carcinoma 2, 3, 4.
- However, there is limited evidence on the interaction between immunotherapy and nutritional supplements, and further research is needed to understand the potential benefits and harms of nutritional supplementation in this context 2, 3, 4.