Malnutrition frequently complicates the clinical course of patients with metastatic solid tumors. Therefore, clinicians must identify effective tools to assess patient prognosis before starting systemic therapies. A recent retrospective study investigated the impact of oral nutritional support (ONS) and the predictive accuracy of various nutritional risk scores in patients treated with immune checkpoint inhibitors (ICIs). The researchers analyzed 538 adults to determine if nutritional interventions or baseline scores correlated with better survival outcomes.

The results indicated that baseline ONS use did not significantly enhance overall survival (OS) or progression-free survival (PFS). Median OS for ONS users was 13.9 months, while non-users reached 11.0 months. Furthermore, ONS did not appear to influence the frequency of immune-related adverse events (irAEs). Despite the lack of survival benefits from supplementation in this cohort, the data revealed that baseline nutritional indices are vital prognostic indicators.

Prognostic Value of Nutritional Risk Scores

The study demonstrated that several validated nutritional risk scores independently predict survival in this population. Specifically, the Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score showed strong associations with OS and PFS. These metrics provide a snapshot of the patient’s immune-nutritional axis. Consequently, they allow oncologists to identify high-risk individuals who may require more intensive monitoring or multidisciplinary care during immunotherapy.

Although ONS did not show a direct survival advantage, maintaining a focus on nutritional status remains essential. Malnutrition often reflects underlying systemic inflammation, which can impair T-cell function and reduce the efficacy of ICIs. Thus, integrating these scoring systems into routine clinical practice can refine prognostic estimates and help tailor treatment strategies for metastatic cancer patients.

Frequently Asked Questions

Which nutritional risk scores are most effective for ICI-treated patients?

The GNRI, PNI, CONUT, and mGPS are all effective independent predictors of overall survival and progression-free survival in metastatic solid tumor patients receiving immunotherapy.

Does oral nutritional supplementation improve survival in metastatic cancer?

According to this study, baseline ONS use did not significantly improve survival outcomes or change the incidence of immune-related adverse events in patients treated with ICIs.

Why is nutritional status important for immunotherapy?

Nutritional status is closely linked to immune function. Poor nutrition and systemic inflammation can create an immunosuppressive environment that may compromise the effectiveness of checkpoint inhibitors.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Refer to the latest local and national guidelines for clinical practice.

References

1. Acar C et al. Evaluating oral nutritional support and the nutritional risk scores in ICI-treated metastatic solid tumours. Immunotherapy. 2026 Apr 20. doi: 10.1080/1750743X.2026.2660558. PMID: 42003385.

2. Tang W et al. Nutritional status, immunonutrition, and gut microbiome: a coming of age for immunotherapy? PMC. 2025.

3. Ignacio et al. Prognostic value of controlling nutritional status on clinical and survival outcomes in cancer patients treated with immunotherapy. PMC. 2023.