Non-pharmacological Supportive Care Interventions during Immunotherapy for People with Cancer: A Systematic Scoping Review and Future Directions

Abstract Purpose Immunotherapy has transformed cancer treatment and outcomes. Patients receiving immunotherapy often encounter immune-related and treatment-related adverse events, leading to substantial supportive care needs. Currently, no recommendations exist to guide the use of non-pharmacological supportive care interventions for people with cancer undergoing immunotherapy treatments. This review aims to summarise the available evidence regarding non-pharmacological supportive care strategies to inform future clinical management and research directions. Methods Six electronic databases (PubMed, CINAHL, EMBASE, PsycInfo, Web of Science and Scopus) were systematically searched for studies on non-pharmacological supportive care interventions for adults undergoing immunotherapy, published from October 2014 to October 2024. Results A total of 5383 studies were screened, with 14 meeting the inclusion criteria. Five were interventional studies and ten were observational. The interventional studies included three physical activity and exercise interventions, two dietary interventions, and one multimodal intervention. Most interventions were found to be feasible, acceptable, and demonstrate preliminary efficacy at improving quality of life, symptom burden, and clinical outcomes. Observational evidence demonstrated associations between physical activity and dietary factors and improved quality of life, reduced symptom burden, and improved clinical outcomes. Conclusion Growing observational and preliminary interventional evidence suggests a multimodal supportive care intervention that includes regular symptom monitoring, dietary support and exercise to address the physical and psychosocial needs of cancer patients undergoing immunotherapy may be beneficial. However, further high-quality trials are needed to confirm their efficacy and inform clinical implementation.