Author Identifier (ORCID)
Cristina Crespo-Garcia: https://orcid.org/0009-0004-8981-3610
Francesco Bettariga: https://orcid.org/0000-0002-4977-5494
Dennis R. Taaffe: https://orcid.org/0000-0001-6381-1597
Carolyn J. Peddle-McIntyre: https://orcid.org/0000-0001-9913-4022
Anna Maria Markarian: https://orcid.org/0000-0003-2863-1544
Daniel A. Galvao: https://orcid.org/0000-0002-8209-2281
Robert U. Newton: https://orcid.org/0000-0003-0302-6129
Abstract
Purpose of Review: While exercise and dietary interventions in patients with cancer undergoing chemotherapy have been demonstrated to be safe and feasible and improve patient-reported outcomes, the effects on treatment efficacy have not been widely examined and remain unclear. This review aimed to examine the effects of exercise, dietary, and combined interventions on tumour response and time-to-event outcomes in patients with cancer undergoing chemotherapy. Recent Findings: A systematic review of intervention studies was conducted based on PRISMA guidelines Databases searched were PubMed, Medline, CINAHL, Embase, and Web of Science. Methodological quality and risk of bias were assessed using the RoB2 and ROBINS-I tools. A total of 21 studies, involving 1,384 cancer patients, were included. Exercise interventions were studied in 13 studies, nine of which were controlled. Two studies reported improvements in tumour response, although none demonstrated a significant impact on survival outcomes. Dietary interventions were investigated in seven studies, all of which used either ketogenic diets or fasting-mimicking diets; three of these studies were controlled and recruited patients with breast cancer. Among all studies, three showed significant increases in tumour response and survival outcomes. Finally, only one study evaluated the combined effects of exercise and diet, reporting a significant increase in pathological complete response rates in the intervention group. Summary: Exercise and dietary interventions, particularly ketogenic and fasting-mimicking diets, may enhance tumour response and survival during chemotherapy in some cases. However, the current evidence is limited and inconsistent. Well-designed randomized controlled trials are needed to better establish the efficacy of these interventions as adjuncts to chemotherapy.
Document Type
Journal Article
Date of Publication
12-1-2025
Volume
14
Issue
1
PubMed ID
41366586
Publication Title
Current Nutrition Reports
Publisher
Springer
School
Exercise Medicine Research Institute / School of Medical and Health Sciences
Creative Commons License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 License.
Comments
This is an Author's Accepted Manuscript of: Crespo-Garcia, C., Bettariga, F., Taaffe, D. R., Peddle-McIntyre, C. J., Campbell, J. P., Jeffery, E., Markarian, A. M., Borsati, A., Avancini, A., Pilotto, S., Galvao, D. A., & Newton, R. U. (2025). Effects of exercise or diet or combined interventions on treatment efficacy of chemotherapy for cancer: A systematic review. Current Nutrition Reports, 14. https://doi.org/10.1007/s13668-025-00702-8
This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s13668-025-00702-8