Nutritional Approach on Management of Diarrhea Induced by EGFR-TKI's in Advanced Non-Small Cell Lung Cancer Patients.

Abstract

Lung cancer remains the leading cause of cancer-related mortality worldwide. Adenocarcinoma is the most prevalent subtype of Non-Small Cell Lung Cancer (NSCLC), and platinum-based chemotherapy is the standard first-line treatment. However, patients harboring EGFR mutations benefit significantly from tyrosine kinase inhibitor (TKI) therapy, which enhances treatment response, prolongs progression-free survival (PFS), and improves overall survival (OS). Despite these advantages, TKI-associated gastrointestinal toxicity, particularly mucositis and diarrhea, poses a major challenge that often affects treatment adherence and patient quality of life. Effective diarrhea management is crucial for maintaining therapeutic continuity, yet current clinical guidelines primarily focus on pharmacological approaches. This review highlights the critical role of nutritional strategies in preventing and mitigating TKI-induced diarrhea. Due to the irritative effects of TKIs on digestion, dietary modifications are crucial. Patients should avoid greasy, spicy, acidic, and high-fiber foods, along with alcohol, soft drinks, and coffee. Steamed, baked, or boiled foods are recommended. Glutamine and probiotics may aid mucosal recovery and microbiota balance. Ongoing nutritional oversight and individualized dietary guidance are essential for patients with NSCLC undergoing TKI therapy. Future research should establish evidence-based dietary guidelines to optimize treatment tolerance, enhance patient well-being, and improve clinical outcomes.