Nutrition as Standard of Care Across the Cancer Continuum: Building Host Resilience Through Proactive Multimodal, Personalized, and AI-Enabled Oncology Care

Evidence supporting the role of nutrition in cancer care is growing rapidly, yet the routine implementation of evidence-based nutritional screening, assessment, and intervention still lags behind. In many settings, nutrition remains treated as supportive care rather than embedded as a true standard of care across the oncology continuum. As a result, nutritional risk is often under-recognized, undertreated, or addressed too late.Failure to identify and treat nutritional risk from diagnosis through survivorship, palliative care, and hospice is associated with poorer oncologic and clinical outcomes, including reduced performance status, impaired treatment tolerance and adherence, increased toxicity and complications, greater healthcare utilization, adverse body composition changes, functional decline, and worse quality and quantity of survivorship. Conversely, proactive rather than reactive nutritional care, particularly when combined with other anabolic stimuli, may improve outcomes in meaningful and measurable ways.This Research Topic aims to shift the conversation from a narrow focus on cachexia alone toward a broader and more actionable framework centered on anabolism, catabolism, host resilience, and body composition in comprehensive cancer care. This includes consideration of maladaptive catabolic states, including cacobolism, as well as the metabolic and physiologic mechanisms through which malnutrition, catabolism, and compromised body composition may influence drug pharmacokinetics, treatment response, toxicity, and recovery. By framing nutrition and oncology in a more integrated and synergistic way, this collection seeks to highlight how nutritional care can contribute not only to supportive care, but also to treatment delivery, function, and survivorship.The Research Topic will also explore the role of integrated assessment strategies, including nutritional screening tools, GLIM-based frameworks, body composition analysis, imaging-derived markers, functional measures, and clinically meaningful biomarkers, many of which remain underused or insufficiently recognized in routine oncology practice. In parallel, it will examine the ethical and health-economic implications of failing to address malnutrition and catabolism across the cancer care continuum, including the impact on institutional efficiency, healthcare costs, and long-term system sustainability.Finally, this collection seeks to define practical implementation strategies for embedding nutritional and anabolic care across diverse settings, including prehabilitation and ERAS programs, outpatient and inpatient oncology, home care, survivorship, palliative care, and hospice. While oncologic goals may differ across these settings, patient-centered and patient-defined goals often remain continuous and can be better supported through early, transparent, and coordinated nutritional care. Contributions addressing digital innovation, remote monitoring, imaging, and artificial intelligence are also welcome, particularly where these approaches can support earlier identification, personalized intervention, and follow-up while remaining grounded in clinical judgment and ethical safeguards.We welcome original research, systematic reviews, meta-analyses, narrative reviews, clinical trials, implementation studies, guidelines, consensus statements, and expert perspectives that advance both scientific understanding and real-world integration of nutritional care in oncology.Key questions this Research Topic seeks to address:• How can nutrition be established as a true standard of care in oncology rather than an optional adjunct?• How can the field shift from a cachexia-centered model toward a broader framework of anabolism, catabolism, host resilience, and metabolic recovery?• What is the evidence linking failure to proactively screen, assess, and intervene with adverse oncologic, clinical, functional, and survivorship outcomes?• What benefits are seen when proactive nutritional and anabolic interventions are embedded early and consistently in cancer care?• How do malnutrition, catabolism, and altered body composition affect drug pharmacokinetics, treatment tolerance, toxicity, and therapeutic response?• Which integrated assessment tools are most useful in clinical practice?• Why has it been difficult to demonstrate consistent outcome benefits in nutrition and multimodal intervention trials, and how should future studies be designed differently?• Which endpoints matter most in nutritional oncology: survival, treatment completion, toxicity, function, quality of life, healthcare utilization, patient-defined goals, or cost?• What are the ethical boundaries and responsibilities surrounding nutritional and anabolic intervention across diagnosis, treatment, survivorship, palliative care, and hospice?• What are the health-economic consequences of neglecting nutritional care, and how might earlier intervention improve institutional and system-level sustainability?• How can multidisciplinary teams translate evidence into consistent clinical practice across diverse care settings?• What is the appropriate role of digital tools and artificial intelligence in nutritional oncology, and where should ethical and practical limits be drawn?Areas of interest include, but are not limited to:• Anabolism, catabolism, host resilience, and cacobolism in comprehensive cancer care.• Prognostic implications of malnutrition, sarcopenia, cachexia, and adverse body composition changes.• Proactive versus reactive nutritional intervention across the cancer continuum.• Pharmacokinetic and physiologic effects of malnutrition and altered body composition.• GLIM criteria, imaging, biomarkers, and functional tools for nutritional assessment and monitoring.• Nutritional supplementation and intervention strategies to improve treatment tolerance and outcomes.• Multimodal approaches integrating nutrition with physical activity, symptom management, sleep, and supportive care.• Anabolic competence as a clinical and research framework.• Trial design and endpoint selection in nutritional oncology and cachexia research.• Implementation strategies in prehabilitation, ERAS, outpatient, inpatient, home care, survivorship, palliative care, and hospice.• Ethical and health-economic implications of nutritional care in oncology.• Telenutrition, remote monitoring, imaging, and AI-guided tools for personalized nutritional care. Topic editors: Faith D. Ottery, Federico Bozzetti, Jann Arends Source: https://www.frontiersin.org/research-topics/81401/nutrition-as-standard-of-care-across-the-cancer-continuum-building-host-resilience-through-proactive-multimodal-personalized-and-ai-enabled-oncology-care