Cancer Genetics and Epigenetics, 2025, Vol.13, No.1, 11-20 http://medscipublisher.com/index.php/cge 17 (Todoric et al., 2016; Turizo-Smith et al., 2024). For instance, reducing inflammatory indicators such as C-reactive protein (CRP) through dietary regulation can help improve the quality of life of chemotherapy patients and alleviate their fatigue (Zhang et al., 2022). Furthermore, controlling inflammation through diet can not only assist anti-inflammatory drugs in exerting their effects but also improve the surrounding environment of the tumor, thereby enhancing the efficacy of surgery, chemotherapy and radiotherapy (Todoric et al., 2016; Turizo-Smith et al., 2024). Integrating anti-inflammatory diets into multidisciplinary cancer treatment plans can comprehensively address tumor symptoms and patients' health issues, contributing to better treatment outcomes. 7 Future Directions and Prospects 7.1 Design considerations for large-scale, multi-center clinical trials Future research on anti-inflammatory diets in the treatment of pancreatic cancer requires the design of large-scale, multi-center clinical trials. Such studies should unify the dietary intervention plan, clearly set up the control group, and use validated dietary assessment tools to reduce bias and ensure the reproducibility of results in different populations (Crusz and Balkwill, 2015; Todoric et al., 2016). Grouping patients based on genetic, metabolic and treatment-related factors is crucial for explaining individual differences and determining the population most likely to benefit from dietary intervention. Long-term follow-up combined with clinical endpoints such as survival, recurrence rate and quality of life is the key to evaluating the true effect of anti-inflammatory diet. The trial should also strengthen the monitoring of dietary compliance and consider the influence of lifestyle factors such as physical activity and drug use to enhance causal relationship inference (Crusz and Balkwill, 2015; Todoric et al., 2016). 7.2 Identification and validation of novel anti-inflammatory nutritional biomarkers The development of this field relies on the discovery and validation of reliable nutritional biomarkers, which need to reflect the intake of anti-inflammatory diets and biological responses. It may include the circulation levels of specific fatty acids (such as ω-3 polyunsaturated fatty acids), short-chain fatty acids or metabolites related to intestinal microbiota activity, as well as inflammatory cytokines and immune cell types (Szczyrek et al., 2021; Kelly et al., 2022; Kelly et al., 2024). The discovery of biomarkers should rely on high-throughput omics techniques and integrate multi-omics data to capture the complex associations among diet, metabolism and inflammation. Verified biomarkers will help to monitor the effect of dietary intervention more precisely, promote the formulation of personalized nutrition strategies, and clarify the mechanism by which anti-inflammatory diets affect the prognosis of pancreatic cancer. They will also support the development of adaptive trial designs and real-time dietary adjustments based on individual biological responses (Szczyrek et al., 2021; Kelly et al., 2022; Kelly et al., 2024). 7.3 Combine dietary intervention with immunotherapy and targeted therapy Existing evidence shows that anti-inflammatory dietary components (such as ω-3 polyunsaturated fatty acids) can enhance the efficacy of cancer immunotherapy by regulating the tumor microenvironment and strengthening the function of immune cells (Soldati et al., 2018; Kelly et al., 2022; Kelly et al., 2024). For instance, in preclinical studies, supplementation of omega-3 fatty acids and inhibition of soluble cyclooxygenase (sEH) has been proven to enhance the effectiveness of immune checkpoint inhibitors and transform unresponsive tumors into immune-sensitive types. Future clinical regimens should explore the synergistic potential of anti-inflammatory diets combined with immunotherapy and targeted drugs to enhance the treatment response rate while minimizing inflammation-related adverse reactions (Soldati et al., 2018; Szczyrek et al., 2021; Khandekar et al., 2022). Combining dietary strategies with standard cancer treatment may provide an overall solution for pancreatic cancer management, optimize the anti-tumor immune effect and the quality of life of patients.
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