Koji Yamanoi

Satitniramai S, et al. J Gynecol Oncol. 2027 ;38:e23. https://doi.org/10.3802/jgo.2027.38.e23

Background: Dietary and nutritional interventions have gained popularity among patients with cancer undergoing treatment due to the high cost of medical treatment and increased health awareness. Diet, nutrition, psychological stress, and adverse events during treatment have a significant impact on the quality of life of patients with cancer. This study aimed to review published studies and guidelines on diet and exercise for cancer survivors. Recent Findings: Although several academic associations have published guidelines on the impact of diet and nutrition on cancer treatment, physicians typically do not consider this impact. Conclusion: This study summarizes recent findings on the effects of diet and nutrition, particularly fasting‐mimicking diet, on the prognosis and adverse events of chemotherapy. Furthermore, this study outlines future perspectives on cancer treatment based on “Precision Nutrition” and “Molecular Precision Medicine”.

Purpose: Appetite loss is common during chemotherapy. However, its association with dietary intake and quality of life (QOL) in patients with gynecologic cancer remains unclear. This study aimed to clarify the dietary changes associated with appetite loss and investigate their association with QOL and adverse events. Methods: Patients with gynecologic cancer receiving chemotherapy were enrolled in this single-center longitudinal observational study. Dietary intake was assessed at baseline and before the third chemotherapy cycle using a diet history questionnaire. Appetite loss, QOL, and adverse events were evaluated using the EORTC QLQ-C30 and PRO-CTCAE. Sensitivity analyses addressed pre-existing appetite loss and postoperative effects. A complementary analysis of a separate cohort examined the association between appetite loss and longitudinal QOL changes. Results: Among 105 patients, 41 (39.0%) reported appetite loss before the third chemotherapy cycle. The appetite loss group showed greater reductions in energy and macronutrient intake, whereas macronutrient composition did not differ between the groups. Absolute micronutrient intake broadly decreased, but no difference remained significant after energy adjustment. Among adverse events, taste changes were most closely associated with appetite loss. Appetite loss was also associated with QOL decline, and dietary findings were directionally consistent in sensitivity analyses. The complementary analysis showed appetite loss was consistently associated with QOL fluctuations. Conclusion: Appetite loss during chemotherapy was associated with reduced dietary intake and lower QOL. Taste alterations were closely associated with appetite loss. These findings support appetite loss as a clinically relevant target for the supportive care of patients with gynecologic cancers.

Supplementary Figure S3 shows the generation and characterization of CDK12 knockdown cell lines using short hairpin RNA (shRNA) in human uterine serous carcinoma and mouse endometrial carcinoma models, including validation of CDK12 protein reduction and effects on cell proliferation.

Supplementary Figure S5 shows that short-term CDK12/13 inhibition by CTX-439 induces DNA damage and enhances cisplatin sensitivity without affecting short-term cell viability in uterine serous carcinoma cell lines.

Supplementary Figure S6 shows dose–response analyses of CTX-439 and olaparib, alone or in combination at different molar ratios, demonstrating enhanced cytotoxic effects of combination treatment in uterine serous carcinoma cell lines.

Supplementary Figure S4 shows suppression of HR-related gene expression and associated protein changes following CTX-439 treatment in uterine serous carcinoma cell lines, as assessed by RT–qPCR and Western blotting.

Supplementary Figure S1 shows RNA-seq–based analyses of transcriptional changes induced by CTX-439 treatment, including pathway enrichment analyses across multiple USC xenograft models and volcano plots highlighting representative cell cycle–related genes.

Supplementary Figure S2 shows HRD status, CDK12 copy number alterations, and related genomic features in uterine serous carcinoma, including correlations with HRD scores and survival analyses in the TCGA and Kyoto University cohorts.