Table 1.

Mechanisms and effects of caloric restriction in cancer Immunotherapy.

Mechanism in Caloric Restriction	Effect	References
Autophagy-Dependent Mechanisms	CR stimulates autophagy, promoting ATP secretion and facilitating DC recruitment, a crucial step in mediating an adaptive antitumor immune response. This effect is particularly potent when combined with therapeutic regimens that induce immunogenic cell death.	[89–92]
Inhibition of Tumor Growth	Fasting and CR synergize with tyrosine kinase inhibitors, including crizotinib, in inhibiting tumor growth. Fasting also improves the response to radio- and chemotherapy in mouse glioma models.	[91–93]
Enhanced T-Cell Activity	Energy reduction interventions enhance CD8 + T cell infiltration into the tumor bed while concurrently reducing regulatory CD4 + T lymphocytes.	[93]
Enhancement of Myeloid Cells and DCs:	Energy reduction can enrich mature monocyte-derived DCs, involving critical CD11b+ myeloid cells.	[94]
Sensitization to Immunotherapy	CR, through various mechanisms, can enhance cancer cell sensitivity to T-cell-mediated killing, supporting the idea of combining CR with immunotherapy.	[95, 96]
Combinatorial Strategies	Combining caloric restriction mimetics with ICD-inducing chemotherapy and ICIs improves therapeutic outcomes in preclinical studies.	[94]