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The continuous effort to ameliorate supportive care represents one of the cornerstones in the improvement of outcomes in pediatric oncology. Nowadays more than ever, nutritional support can be considered a key component. Children with cancer are at high risk for developing short-term and long-term ...

The continuous effort to ameliorate supportive care represents one of the cornerstones in the improvement of outcomes in pediatric oncology. Nowadays more than ever, nutritional support can be considered a key component. Children with cancer are at high risk for developing short-term and long-term nutritional problems related to their underlying disease and side effects of multimodal treatments. Improving nutritional status could influence clinical outcomes, reducing treatment-related toxicities and overall mortality.

In this Research Topic, we would like to address the emerging role of nutritional support in the supportive care of pediatric patients with cancer. There is currently a lack of a systematic approach to this issue in the pediatric oncology population and standard recommendations for nutritional care are lacking, as pointed out by the recent clinical practice survey conducted by the Nutrition Committee of the Children’s Oncology Group (COG).

First, an in-depth analysis of how nutritional assessment should be performed could improve clinical evaluation and provide stronger data on the correlation with clinical outcomes. Moreover, while evidence on adult patients is consistent, data regarding the importance of the nutritional state as a prognostic factor in pediatric populations are only a few and more specific studies are warranted.

If nutritional status can be considered a modifiable prognostic factor, it can potentially be improved through adequate nutritional support. Several strategies could be applied in different clinical settings, but data in the literature are scarce and should clearly be a focus of this Research Topic. Other topics of interest include interventions aimed at improving gut eubiosis as they could provide effective ways to modulate the gut microbiota in order to improve clinical outcomes. These strategies range from nutritional supplements such as pre- and pro-biotics to fecal microbiota transplantation, and are starting to be applied in oncological patients. However, there is no unified perspective on the characteristics of the mechanistic link between microbiome, diet, and clinical outcome. Therefore, further studies are needed, particularly in the pediatric population given their distinctive microbiome signature.

Keywords: Nutrition, Pediatric Cancer, Diet, Nutritional Evaluation, Enteral Nutrition, Parenteral Nutrition, Nutritional Status, Prebiotics, Probiotics, Gut microbiome, pediatrics, short chain fatty acids


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