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    					| Research progress on nutritional status and prognosis of immunotherapy in patients with malignant tumors | 
  					 
  					  										
						| 1Lu Siyi,2Luo Liqiong | 
					 
															
						| 1First Clinical College of Wuhan University of Science and Technology Wuhan 430064 Hubei China 
2Department of Oncology Tianyou
Hospital Affiliated to Wuhan University of Science and Technology Wuhan 430064 Hubei China | 
					 
										
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													     		                            						                            																	    Abstract  Nutritional and metabolic status demonstrates dynamic interplay with immune function status and immunotherapy efficacy
 including treatment - related toxicity tolerance in cancer patients and shows significant correlation with immunotherapy
prognosis. Macroscopically tumor-associated metabolic disorders encompassing host anti-tumor stress responses and cancer-derived
metabolic abnormalities trigger protein - energy wasting imbalance accompanied by reduced dietary intake and activity restriction 
leading to progressive malnutrition or even cachexia which further diminishes immunotherapy response rates and treatment
tolerance. Microscopically the nutrient - deprived hypoxic and acidotic tumor microenvironment disrupts immune cell metabolic
reprogramming thereby suppressing their antitumor efficacy and establishing a vicious cycle of immune escape. Nutritional assessment
constitutes a crucial component of baseline evaluation prior to cancer immunotherapy enabling clinicians to better identify beneficiaries
from immunotherapy and formulate personalized treatment strategies. Consequently prognostic indicators integrating nutritional and
immune parameters e. g. prognostic nutritional index geriatric nutritional risk index have emerged as potential biomarkers for
predicting immunotherapy outcomes. This review synthesizes current understanding of cancer-associated metabolic characteristics their
immunomodulatory impacts and advances in nutritional biomarkers for immunotherapy prognosis prediction aiming to provide clinical
reference value.
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