Cancer cells acquire distinct metabolic preferences based on their tissue of origin, genetic alterations and degree of interaction with systemic hormones and metabolites. These adaptations support the increased nutrient demand required for increased growth and proliferation. Diet is the major source of nutrients for tumours, yet dietary interventions lack robust evidence and are rarely prescribed by clinicians for the treatment of cancer. Well-controlled diet studies in patients with cancer are rare, and existing studies have been limited by nonspecific enrolment criteria that inappropriately grouped together subjects with disparate tumour and host metabolic profiles. This imprecision may have masked the efficacy of the intervention for appropriate candidates. Here, we review the metabolic alterations and key vulnerabilities that occur across multiple types of cancer. We describe how these vulnerabilities could potentially be targeted using dietary therapies including energy or macronutrient restriction and intermittent fasting regimens. We also discuss recent trials that highlight how dietary strategies may be combined with pharmacological therapies to treat some cancers, potentially ushering a path towards precision nutrition for cancer.

癌细胞根据其组织来源、遗传改变以及与全身激素和代谢物相互作用的程度而获得不同的代谢偏好。这些适应支持增加生长和增殖所需的营养需求。饮食是肿瘤营养的主要来源，但饮食干预缺乏强有力的证据，临床医生很少开出治疗癌症的处方。对癌症患者进行良好控制的饮食研究很少见，现有研究受到非特异性入选标准的限制，这些标准不适当地将具有不同肿瘤和宿主代谢特征的受试者分组在一起。这种不精确性可能掩盖了对合适的候选人进行干预的有效性。这里，我们回顾了多种癌症发生的代谢改变和关键弱点。我们描述了如何使用包括能量或常量营养素限制和间歇性禁食方案在内的饮食疗法来潜在地针对这些脆弱性。我们还讨论了最近的试验，这些试验强调了饮食策略如何与药物疗法相结合来治疗某些癌症，从而可能为癌症的精准营养开辟一条道路。