The following is a summary of “Comparison of the effectiveness of integrative immunomodulatory treatments and conventional therapies on the survival of selected gastrointestinal cancer patients,” published in the November 2023 issue of Gastroenterology by Kleef et al.

Over the past decade, there has been a notable rise in the utilization of immunomodulating treatments (IMTs) within integrative oncology practices (IOP). These IMTs are employed to manipulate the tumor microenvironment, potentially enhancing treatment response and broadening the applicability of immune checkpoint inhibitors. The study aimed to assess the effectiveness and safety of IMTs compared to conventional chemo(radio)therapy (CT) in patients with advanced or metastatic gastrointestinal cancers. Among the participants, 21 had colorectal cancer (CRC), 14 had pancreatic cancer (PC), 5 had cholangiocellular carcinoma (CCC), 5 had gastric cancer (GC), and 4 had esophageal cancer (EC), all receiving IMT. 

The IMT group was compared to a CT cohort from an academic oncology center, specifically in CRC and PC patients. Following IMT initiation, patients exhibited a median survival of approximately 20 months (CRC, PC, and EC) and 10 months (CCC and GC). Notably, locoregional modulated electro-hyperthermia showed the most favorable impact on overall survival (HR: 0.3055; P = 0.0260), followed by fever-inducing interleukin-2 and low-dose ipilimumab, which displayed a promising trend. The study identified IMT as superior to CT in PC patients (HR: 0.1974; P = 0.0013), whereas a modest effect was observed in CRC patients (HR: 0.7797; P = 0.4710). Nevertheless, IMTs exhibited minimal influence on patient survival across the entire study population, with CT demonstrating the most significant impact, particularly when introduced at an early stage (HR: 0.0624; P < 0.0001). 

While the integrative IMTs presented in this study showed limited effects on the survival of gastrointestinal cancer patients, a potential benefit was observed in PC cases, warranting further investigation.

Source: nature.com/articles/s41598-023-47802-5