Prior systematic reviews addressing the impact of diet on cancer outcomes have focused on specific dietary interventions. In this systematic review, we assessed all RCTs investigating dietary interventions for cancer patients, examining the range of interventions, endpoints, patient populations, and results.
This systematic review identified all RCTs conducted prior to January 2023 testing dietary interventions in patients with cancer. Assessed outcomes included quality of life, functional outcomes, clinical cancer measurements (eg, progression-free survival, response rates), overall survival, and translational endpoints (eg, inflammatory markers).
252 RCTs were identified involving 31,067 patients. The median sample size was 71 (interquartile range 41 to 118), and 80 (32%) studies had a sample size greater than 100. Most trials (n = 184, 73%) were conducted in the adjuvant setting. Weight/body composition and translational endpoints were the most common primary endpoints (n = 64, 25%; n = 52, 21%, respectively). Direct cancer measurements and overall survival were a primary endpoint in 20 (8%) and seven (3%) studies respectively. Eight trials with a primary endpoint of cancer measurement (40%) met their endpoint. Large trials in colon (n = 1429), breast (n = 3088), and prostate cancer (n = 478) each showed no effect of dietary interventions on endpoints measuring cancer.
Most RCTs of dietary interventions in cancer are small and measure non-clinical endpoints. Although only a small number of large RCTs have been conducted to date, these trials have not shown an improvement in cancer outcomes. Currently, there is limited evidence to support dietary interventions as a therapeutic tool in cancer care.
Journal of the National Cancer Institute. 2024 Mar 01 [Epub ahead of print]
Nosakhare Paul Ilerhunmwuwa, Abul Hasan Shadali Abdul Khader, Calvin Smith, Edward R Scheffer Cliff, Christopher M Booth, Evevanne Hottel Rd, Muhammad Aziz, Wade Lee-Smith, Aaron Goodman, Rajshekhar Chakraborty, Ghulam Rehman Mohyuddin
One Brooklyn Health/Brookdale University Hospital and Medical Center, Brooklyn, NY, USA., Government Kilpauk Medical College, India., Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT, USA., Program on Regulation, Therapeutics and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada., Dietician, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA., Mulford Health Science Library, University of Toledo, Toledo, OH, USA., Division of Blood and Marrow Transplantation, University of California San Diego, San Diego, CA, USA., Division of Hematology, Columbia University Cancer Center, New York, NY, USA., Division of Hematology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.