MS-N153 · Dietary pattern · Immunotherapy · Melanoma · Prospective cohort · Appraised 27 October 2026
Is a Mediterranean-style dietary pattern associated with response to immune-checkpoint blockade in advanced melanoma?
Evidence at a glance
- Evidence label: Promising association; not evidence that diet caused response
- Benefit: Greater adherence was associated with higher modeled probabilities of objective response and 12-month progression-free survival.
- Certainty: Low for causality. The cohort included 91 patients, diet was self-reported and not randomized, and the models were exploratory.
- Risk: A balanced Mediterranean-style pattern is generally low risk, but weight loss, low protein intake, food interactions and restrictive versions can be harmful during treatment.
What was studied
The PRIMM multicenter cohort prospectively followed 91 immune-checkpoint-blockade–naive patients with advanced melanoma in the Netherlands and United Kingdom. Baseline food-frequency questionnaires estimated an alternate Mediterranean diet score.
What the evidence found
Higher adherence showed positive associations with objective response and 12-month progression-free survival; modeled probabilities were 0.77 for response (P=0.02) and 0.74 for PFS at 12 months (P=0.01). These probabilities are model outputs, not absolute trial effects.
How to interpret it
People who eat differently may also differ in treatment, disease burden, exercise, body composition, healthcare access and microbiome. The study does not show that starting this diet changes an individual’s response or survival.
Practical safety context
Avoid unintentionally reducing calories or protein during active weight loss or cachexia. Food safety, anticoagulation, kidney disease and treatment-specific restrictions should shape the plan. A plant-forward version can be built without fish or animal products.
Questions for the care team
- Can this pattern be adapted to current calorie and protein needs?
- Are there treatment-specific food restrictions or bowel symptoms?
- Would referral to an oncology dietitian prevent unnecessary restriction?
Funding and conflicts
The Seerave Foundation supported the work. Investigators disclosed relationships with Zoe and multiple pharmaceutical companies. Published in 2023.
Sources
Last literature search: 27 October 2026. Record appraisal: 27 October 2026. This page is educational and does not replace individualized medical advice. Symptom, biomarker, immune-marker or nutritional changes must not be interpreted as proof of tumor control, recurrence prevention or longer survival unless those outcomes were directly tested.
