Evidence-based guideline on immunonutrition in patients with cancer

Background: Malnutrition in patients with malignant tumors caused by the tumor or related treatment is a significant problem in clinical practice. “Cancer immunonutrition” therapy improves patients’ nutritional condition and immune function. It uses specific nutrients to improve the nutritional status of patients with cancer and regulates the body’s immune and inflammatory responses. To date, cancer immunonutrition has been used in surgery, chemoradiotherapy, hematopoietic stem cell transplantation (HSCT), treatment of tumor complications, and other fields. Therefore, we aimed to develop rigorous and detailed evidence-based practice guidelines for cancer immunonutrition therapy. Methods: The guideline strictly followed the latest guidelines from the Institution of Medicine and was constructed according to the World Health Organization handbook for guideline development. It was written according to the Reporting Items for practice Guidelines in Healthcare criteria. The quality of evidence and strength of the recommendations were assessed using the Grading of Recommendations Assessment, Development, and Evaluation method. Results: Twenty-three recommendations were formulated regarding surgery, chemoradiotherapy, HSCT, treatment of tumor complications, and other fields. Conclusions: We developed clinical practice guidelines for cancer immunonutrition therapy based on the latest evidence-based practice to provide more comprehensive and detailed advice to healthcare providers. This guideline broadens the application scope of immunonutrition therapy for cancer and promotes its standardized application in clinical practice.