Gina Mauro

Greek yogurt, egg salad, avocado and mac and cheese are easy-to-swallow, high-calorie foods that can help patients maintain strength during cancer treatment.

Kanisha Parikh, a dietitian at John Theurer Cancer Center, shares tips with CURE for helping patients with cancer maintain nutrition when eating becomes difficult.

Greek yogurt, egg salad, tuna with mayo, mashed avocado and gooey mac and cheese are soft, high-calorie options that are easy to swallow and rich in protein. Chopping foods finely and adding sauces helps in the early stages of cancer treatment, while blending or choosing naturally soft foods like pudding may be best as symptoms progress.

For patients experiencing taste changes due to cancer therapy, Parikh suggests boosting flavor with extra spices and using tomato or citrus to enhance meals. When appetite is low or eating is painful — small, frequent meals with full-fat dairy, olive oil and protein shakes can help preserve weight and muscle. For hydration, broths, ice pops and juicy fruits may be easier than plain water, according to Parikh.

Parikh also shared a creamy lentil soup recipe on CURE

, made with tomatoes, warming spices, olive oil and milk for added calories and comfort. The soup can be puréed for easy swallowing and stored in portions for quick, nourishing meals.

CURE: What are some high-calorie, high-protein foods that are easy to swallow for a patient with cancer?

: Foods that are easy to swallow include Greek yogurt, because it’s nice and thick, and other soft, moist options. Chicken salad or tuna fish with a good amount of mayonnaise, egg salad, mashed avocado — even cheesy, gooey mac and cheese — all of those are easier to swallow and provide both protein and calories.

Are there specific textures or food prep methods, like blending or puréeing, that make eating easier or more comfortable, especially with spices?

Definitely. At the beginning stages of treatment, chopping foods very finely — without needing to fully purée them — and adding sauces, gravies or other liquids to keep things moist is really helpful. As time goes on, it might be best to move toward puréed foods using a blender or immersion blender. Or you can choose naturally soft foods like yogurt or pudding.

What tips do you have for patients who have lost their sense of taste or have altered taste due to treatment?

One tip is to really pack on the seasoning — use more spices and seasonings than you normally would, since the sense of taste is diminished. Two flavors that still tend to come through well are tomato and citrus. Cooking something like soft meatballs in tomato sauce, or adding lemon juice to chicken or tuna salad, can help enhance flavor.

How can patients maintain their weight and muscle mass if eating becomes painful or they have little appetite?

In those cases, small, frequent meals are key. Focus on calorie- and protein-dense foods — use full-fat dairy, add olive oil, and choose high-calorie options. Protein shakes, whether store-bought or homemade, are also a great way to get in extra nutrition.

How can patients stay hydrated when water feels uncomfortable or causes coughing?

There are alternatives to plain water. If swallowing is safe, try thicker options like broth-based soups or gelatin. Ice pops can also help, as can water-rich foods like watermelon and cucumbers — either sucking on them or eating them, depending on what’s manageable.

How can caregivers support healthy eating habits for loved ones undergoing treatment?

One of the most helpful things caregivers can do is prepare meals. Fatigue is common, so having meals ready to go — especially ones that are soft, moist and easy to swallow — can make a big difference in helping patients maintain their nutrition.

Transcript has been edited for clarity and conciseness.

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Articles

Maintaining nutrition during cancer treatment can be challenging due to symptoms like taste changes and difficulty swallowing. High-calorie, high-protein soft foods such as Greek yogurt, egg salad, and mac and cheese are recommended. Enhancing flavors with spices, tomato, or citrus can help with taste alterations. Small, frequent meals with full-fat dairy and protein shakes are advised for those with low appetite. Hydration can be maintained with broths, ice pops, and juicy fruits. Caregivers can support by preparing easy-to-swallow meals to help patients maintain their nutrition.

Eating Tips for When Cancer Treatment Makes Meals Challenging

Dr. Andre Henri Goy shared how CAR T-cell therapy led a retired pilot with lymphoma into remission, showing the impact of personalized treatment decisions.

CAR T-Cell Therapy Leads to Remission in Retired Air Force Pilot With Lymphoma 

Dr. Andre Henri Goy of John Theurer Cancer Center shared the story of a patient with lymphoma who achieved remission after CAR T-cell therapy, illustrating how individualized treatment decisions can lead to long-term outcomes and renewed quality of life.

Goy described how a patient named Mark Daniel first came to him nearly two decades ago with low-grade lymphoma. Daniel responded well to an immunotherapy-based clinical trial and remained active for years — flying planes, exercising daily and staying in great shape.

Years later, Daniel returned with a very aggressive lymphoma. Given the intensity of chemotherapy needed and the patient’s age, CAR T-cell therapy became the most appropriate option. After some complications from initial chemotherapy, Goy convinced Daniel to undergo CAR T-cell therapy, which led to a full recovery and sustained remission. He is now back in the air performing aerobatic flying.

Goy highlighted the importance of tailoring therapy to the patient, noting that CAR T-cell therapy can be especially valuable for individuals with aggressive disease who may not tolerate traditional options. “If we can give back and help them have a better life, it’s a good thing,” he said.

Goy serves as physician in chief of Oncology Care Transformation Services at Hackensack Meridian Health. He is also chairman and chief physician officer of John Theurer Cancer Center and leads the lymphoma division at the center’s location within Hackensack University Medical Center.

How do you determine when a patient is a good candidate for CAR T-cell therapy?

It’s a really important question. We'll take the example of Mark Daniel, because an example is really — well, obviously very important — and then we'll talk a little bit more generally about how we can make things better.

So, Mark Daniel came to see me almost 20 years ago with a low-grade lymphoma. At that time, he really didn’t want to get chemotherapy and qualified for a trial we had for patients receiving first-line therapy that was essentially immunotherapy — a combination that included Rituxan (rituximab) with a small molecule. He did really well — so much so that it sort of disappeared. This is an avid pilot, a retired pilot from the U.S. Air Force, a commercial pilot, still flying, doing aerobatic flying now, and at the gym every day. Amazing shape. Great guy.

He came to see me about two and a half, three years ago with a very aggressive new lymphoma — a very large mass in his abdomen causing pain. Initially, he thought this was because he overdid it with exercise. But we found the mass, and when we did a biopsy, it was a very high-grade, aggressive lymphoma.

In that situation, you need to give a more intensive regimen, but it would be very toxic for him at his age — even though he was in good shape. So, we had to give him some chemotherapy to slow down the process. He had a lot of complications because of the mass’s location — with risk of perforation and so on. He was really not eager to continue chemotherapy and wanted to give up.

I convinced him to actually agree to do the CAR T-cell therapy, and then he went into complete remission. Not only did he do really well during the CAR T-cell therapy, but he recovered fully. Now, he’s been in remission for well over a year, and he's back on his plane, flying and doing aerobatic flying.

It’s a double success. It’s a great opportunity to treat someone who is fantastic, but also a veteran who was part of the U.S. Air Force in Vietnam. If we can give back and help them have a better life, it’s a good thing.

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Kisqali plus hormone therapy improved 4-year outcomes across age and menopausal status in early hormone receptor–positive, HER2-negative breast cancer.

Among patients with stage 2/3 hormone receptor–positive, HER2-negative early breast cancer, Kisqali (ribociclib) plus nonsteroidal aromatase inhibitor (NSAI) showed consistent benefits in invasive disease-free survival (iDFS), distant disease-free survival (DDFS), recurrence-free survival (RFS) and distant relapse-free survival (DRFS), according to an analysis of the phase 3 NATALEE trial presented at the 

At a median follow-up of 44.2 months, results showed that the 4-year iDFS rates in premenopausal patients were 90.6% with the Kisqali-plus-NSAI regimen with letrozole or anastrozole (1115 patients) versus 85.3% with a NSAI alone (1123 patients). In postmenopausal patients, the 4-year iDFS rates were 86.8% with the Kisqali-plus-NSAI regimen versus 82.2% with NSAI alone, which was a Δ4.6% absolute improvement.

“This analysis showed that [Kisqali] in combination with letrozole or anastrozole lowered the chance of the cancer returned was safe to use in a broad population of patients with HR-positive, HER2-negative early breast cancer,” lead study author Dr. Kevin Kalinsky, professor and director in the Division of Medical Oncology of the Department of Hematology and Medical Oncology at Emory University School of Medicine, and the director of the Glenn Family Breast Center at Winship Cancer Institute, said in an oral presentation during the meeting. “[Kisqali] plus a NSAI provides treatment benefit to a broad range of patients with stage 2/stage 3 HR-positive, HER2-negative early breast cancer across menopausal status and age.”

Although survival outcomes in patients with hormone receptor–positive, HER2-negative early breast cancer have improved with the use of adjuvant endocrine therapy, there is still a risk of recurrence, influenced by menopausal status and age, Kalinsky explained.

Invasive disease-free survival (iDFS): time after treatment during which no invasive breast cancer returns or spreads.

Distant disease-free survival (DDFS): time after treatment without cancer returning in distant parts of the body.

Recurrence-free survival (RFS): time after treatment during which cancer does not come back in any form.

Distant relapse-free survival (DRFS): time after treatment that a patient lives without the cancer coming back in distant organs.

Nonsteroidal aromatase inhibitor (NSAI): type of hormone therapy that lowers estrogen levels to slow or stop hormone receptor–positive breast cancer.

ECOG performance status: scale used to measure how a disease affects a patient’s daily living abilities.

Time to deterioration (TTD): how long it takes for a patient’s health or physical function to worsen.

EORTC QLQ-C30: a questionnaire used to assess quality of life in people with cancer.

Δ (Delta): symbol used to show the difference in percentage points between two treatment outcomes.

To be eligible for NATALEE, patients must have had hormone receptor–positive/HER2-negative early breast cancer and prior endocrine therapy was permitted within 12 months prior to randomization. Patients had to have:

anatomical stage 2a disease, which could be N0 with grade 2 and evidence of high risk, a Ki-67 of at least 20%, Oncotype DX Breast Recurrence Score at least 26 or high risk via genomic risk profiling, or grade 3, or N1 disease;

or anatomical stage 3, which was N0, N1, N2 or N3.

Patients who were premenopausal were required to undergo ovarian suppression.

A total 5101 patients were randomized 1:1 to receive 400 milligrams of daily Kisqali on a three-weeks-on/1-week-off schedule for three years plus an NSAI regimen of letrozole or anastrozole for at least five years plus goserelin in men and premenopausal women, or the NSAI regimen alone.

The primary end point was iDFS using STEEP criteria; secondary end points were RFS, DDFS, overall survival, safety and tolerability, patient-reported outcomes and pharmacokinetics.

Stratification factors included anatomical stage (2 versus 3), menopausal status (men and premenopausal women versus postmenopausal women), receipt of prior neo(adjuvant) chemotherapy (yes versus no), and geographic location (North America/Western Europe/Oceania versus rest of world).

Prior NATALEE data showed a statistically significant benefit with iDFS with Kisqali plus NSAI versus NSAI alone in a larger population of patients with hormone receptor–positive/HER2-negative early breast cancer at risk of recurrence. Additionally, the absolute iDFS benefit had increased to 4.9% in a 4-year landmark analysis and was observed across subgroups.

In the analysis presented at the 2025 ASCO Annual Meeting, investigators reported on 4-year efficacy, safety and quality-of-life (QOL) outcomes with Kisqali plus NSAI specific to menopausal status and age from the NATALEE study.

Kalinsky noted that more premenopausal patients versus postmenopausal had an ECOG performance status of 0 (86.8% versus 80.1%, respectively), Ki-67 greater than 20% (39.9% versus 34.4%), stage 3 (62.2% versus 58.3%), N1 to N3 nodal stage (63.4% versus 56.9%) and T3/T4 tumors (28.7% versus 24.0%) at diagnosis.

The data cutoff date was April 29, 2024. Efficacy outcomes were further explored via menopausal status and then grouped by age. Overall, in premenopausal patients, the 4-year DDFS rates were 91.6% with Kisqali/NSAI and 86.6% with NSAI alone, 4-year RFS rates were 92% and 86.6%, respectively, and 4-year DRFS rates were 92.7% and 87.6%, respectively.

When examined in premenopausal patients younger than 40 years, the absolute benefit rate with Kisqali (237 patients) versus NSAI alone (276 patients) across iDFS, DDFS, RFS and DRFS end points were Δ6.3%, Δ7%, Δ5.5% and Δ6.5%, respectively.

These rates were slightly lower in premenopausal patients 40 years or older with Kisqali (878 patients) versus NSAI alone (847 patients): iDFS (Δ5%); DDFS (Δ4.4%), RFS (Δ5.3%) and DRFS (Δ4.7%).

The same analysis was conducted in postmenopausal patients. Overall, in this subgroup, the 4-year DDFS rates were 87.7% versus 83.6% with Kisqali or NSAI, respectively (Δ4.1%). The 4-year RFS rates were 88.8% versus 84.5% (Δ4.3%), and the 4-year DRFS rates were 89.2% versus 85.6% (Δ3.6%).

The outcomes were explored further in postmenopausal patients younger than 60 years. The absolute benefit rate with Kisqali (703 patients) versus NSAI alone (735 patients) across iDFS, DDFS, RFS and DRFS end points were Δ2.7%, Δ2.2%, Δ2.8% and Δ2.1%, respectively.

These absolute benefit rates were higher in postmenopausal patients 60 years or older with Kisqali (721 patients) versus NSAI alone (685 patients): iDFS (Δ6.4%); DDFS (Δ5.9%), RFS (Δ5.8%) and DRFS (Δ5%).

Kalinsky emphasized that the trial was not powered to detect differences with these exploratory analyses, adding that the data should be interpreted with caution.

Safety and dose modifications due to adverse effects (AEs) were examined by menopausal status. Kalinsky highlighted that in premenopausal patients overall (2178 patients), the Kisqali discontinuation rate due to AEs was 16.1%, and 75.4% discontinued without dose reductions; in patients younger than 40 years, these respective rates were 10.5% and 52%, and in patients 40 years and older, they were 17.5% and 79.2%, respectively.

The Kisqali dose reduction rate due to AEs was 22.4% in all premenopausal patients, followed by 27% and 21.1% in patients younger than 40 years and at least 40 years old, respectively.

“Premenopausal women were more likely to discontinue [Kisqali] without having had a dose reduction,” Kalinsky said.

In postmenopausal patients overall (2771 patients), the Kisqali discontinuation rate was 22.9% and 67.5% stopped treatment without experiencing dose reductions. These rates were 17.8% and 68% in patients younger than 60 years and 27.9% and 67.2% in patients 60 years and older. The Kisqali dose reduction rate due to AEs was 23.6% in all postmenopausal patients, followed by 24.2% and 22.9% in patients younger than 60 years and at least 60 years old, respectively.

Time to deterioration (TTD) in global health status (GHS) and physical functioning scales of the EORTC QLQ-C30 was similar between arms for all patient subgroups.

“Efficacy and safety of Kisqali plus nonsteroidal aromatase inhibitor in NATALEE: analysis across menopausal status and age” by Dr. Kevin Kalinsky, et al., 

“Kisqali plus endocrine therapy in early breast cancer” by Dr. Dennis Slamon, et al., 

“Adjuvant Kisqali plus nonsteroidal aromatase inhibitor in hormone receptor–positive/HER2-negative early breast cancer: 4-year outcomes from the NATALEE trial” by Dr. Peter Fasching, et al., 

For more news on cancer updates, research and education, don’t forget to 

Kisqali (ribociclib) combined with a nonsteroidal aromatase inhibitor (NSAI) demonstrated significant benefits in invasive disease-free survival (iDFS), distant disease-free survival (DDFS), recurrence-free survival (RFS), and distant relapse-free survival (DRFS) for patients with stage 2/3 hormone receptor-positive, HER2-negative early breast cancer. The phase 3 NATALEE trial showed improved outcomes across menopausal status and age groups, with notable efficacy in premenopausal patients. Safety profiles were consistent, with manageable adverse effects. The trial's exploratory analyses suggest caution in interpreting subgroup differences, emphasizing the need for further research.

Kisqali plus aromatase inhibitor improved outcomes across age and menopausal status in early hormone receptor–positive, HER2-negative breast cancer.

Kisqali Benefit Lasts Across Age in Breast Cancer Subset

Real-world data from the U.S. confirms the effectiveness of Monjuvi for treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

The real-world effectiveness of Monjuvi (tafasitamab-cxix) in U.S. patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) was confirmed, along with factors associated with survival, according to data from a retrospective medical chart review presented at the 

At a median follow-up time of 14.7 months from Monjuvi initiation, the real-world progression-free survival (PFS) with Monjuvi was 11.3 months in the overall population (181 patients), and the real-world overall survival (OS) was 24.8 months. The real-world overall response rate (ORR) to the agent was 73.5%, which comprised a complete response (CR) rate of 23.2% and a partial response (PR) rate of 50.3%. In the patients who achieved a real-world CR or PR with the agent (133 patients), the real-world duration of response (DOR) was 9.6 months.

An analysis showed that factors significantly linked with increased risk of progression included receiving the agent in the third to fifth line (51 patients) versus the second line (130 patients), having Ann Arbor stage 3 to 4 disease (169 patients) versus stage 1 to 2 (10 patients), increasing Charlson Comorbidity Index scores (181 patients) and bulky (36 patients) versus non-bulky (145 patients) disease.

Moreover, factors significantly associated with increased risk of mortality included receiving Monjuvi in the third to fifth line versus the second line, increasing age, ECOG performance status of 2 or higher versus below 2 and bulky versus non-bulky disease.

Progression-free survival (PFS): time without disease worsening.

Overall survival (OS): time until death from any cause.

Overall response rate (ORR): percentage of patients with tumor reduction.

Complete response (CR): no detectable cancer.

Partial response (PR): tumor reduction, but not complete.

Duration of response (DOR): time response lasts.

Stable disease (SD): cancer neither grows nor shrinks.

Ann Arbor stage: system to classify lymphoma spread.

Charlson Comorbidity Index scores: predicts mortality based on comorbidities.

Non-bulky disease: small or no large tumor mass.

ECOG performance status: measures a patient's ability to perform daily activities, with scores from 0 (fully active) to 5 (dead). Higher scores indicate greater impairment.

“The additional follow-up from the initial data collection allowed for a more robust evaluation of the real-world effectiveness of [Monjuvi] in patients with relapsed or refractory DLBCL, predominantly in the community practice setting,” lead study author Dr. Kim Saverno of Incyte Corporation, in Wilmington, Delaware, said in a poster presentation of the data. “These results support a real-world clinical benefit for [Monjuvi], with the greatest benefit observed when [the agent] was received in second versus later lines of therapy.”

Additional treatment outcome data showed that in those who received Monjuvi in the second line (130 patients), the real-world ORR was 78.5%; this was comprised of a CR rate of 27.7% and a PR rate of 50.8%. For this group, the stable disease (SD) rate was 8.5%, the progressive disease (PD) rate was also 8.5%, and 4.6% of patients did not have these data available. In the group of patients who received the immunotherapy in the third line (43 patients), the real-world ORR was 62.8%; this comprised a CR rate of 11.6% and a PR rate of 51.2%. In this subset, the SD and PD rates were 18.6% and 11.6%, respectively; 7% of patients did not have these data available.

In patients who experienced a real-world CR as a best response to Monjuvi (42 patients), the median real-world DOR was 19.2 months. In those who achieved a real-world PR as a best response to the agent (91 patients), the median real-world DOR was 8.5 months.

The CD19-targeted immunotherapy Monjuvi was approved by the FDA in July 2020 for use in combination with Revlimid (lenalidomide) in adult patients with relapsed or refractory DLBCL not otherwise specified, including DLBCL arising from low-grade lymphoma and who are not candidates to undergo autologous stem cell transplant. To date, few studies have evaluated the agent in a US real-world setting, according to Saverno. She added that data from a real-world study were previously shared, but had a limited follow-up time of 6.5 months, which “precluded robust evaluations of the clinical effectiveness” of the agent.

For patients to be considered eligible for the analysis, they must have started treatment with Monjuvi with or without concomitant Revlimid for relapsed or refractory disease on or following Oct. 21, 2020; be at least 18 years old at the time treatment with the agent was started; and have undergone at least four months of follow-up since treatment started. Those who died during this four-month interval were still permitted. If patients received the agent as part of an interventional clinical trial, they were excluded.

A total of 181 patients were included in the study; 144 of these patients were still alive at last follow-up of initial data collection which had occurred between Feb. 22, 2023, and March 29, 2023. Of those patients, 137 patients had additional follow-up data available and underwent additional data collection between Dec. 18, 2023, and Jan. 31, 2024. A total of 106 patients were alive at last follow-up.

“Over 70% of patients received [Monjuvi] in the second line, and 71% of patients had discontinued [Monjuvi] at the last follow-up, mostly due to disease progression,” Saverno noted. “Over half of the patients were still alive at the last follow-up, and among the patients still alive, half [were] still receiving [Monjuvi] at the time of the most recent follow-up.”

In the 181 total patients, the median age at the time of Monjuvi initiation was 71.1 years. Most patients were White (64.1%), and more than half of patients were male (56.4%). Regarding Ann Arbor stage at time of treatment initiation, 5.5% had stage 1 or 2 disease, 93.4% had stage 3 or 4 disease; this information was unknown for 1.1% of patients. ECOG performance status at the time of treatment initiation was 0 to 1 for 52.5% of patients and 2 or higher for 47.5% of patients. Revised International Prognostic Index for Diffuse Large B-cell Lymphoma was 3 to 5 for 80.5% of patients and 1 to 2 for 19.5% of patients.

“This study is impacted by limitations inherent to real-world studies, such as unobserved and missing data,” Saverno concluded. “The number of participating oncologists was small and thus may not reflect the treatment patterns of all US oncologists managing patients with DLBCL.”

“Real-world effectiveness of tafasitamab (tafa) for the treatment of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) in the United States.” By Dr. Kim Saverno et al, 

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Monjuvi (tafasitamab-cxix) demonstrates real-world effectiveness in U.S. patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), with a progression-free survival of 11.3 months and overall survival of 24.8 months. The study highlights the importance of early-line treatment, as second-line therapy shows better outcomes compared to later lines. Factors such as disease stage, comorbidity index, and performance status significantly impact progression and mortality risks. Despite limitations, the study supports Monjuvi's clinical benefit, especially when administered in earlier treatment lines.

The real-world effectiveness of Monjuvi for relapsed or refractory diffuse large B-cell lymphoma in the U.S. was demonstrated, according to data from a retrospective analysis.

Gina Mauro

Eating Tips for When Cancer Treatment Makes Meals Challenging

CAR T-Cell Therapy Leads to Remission in Retired Air Force Pilot With Lymphoma

Kisqali Benefit Lasts Across Age in Breast Cancer Subset

Real-World Data May Confirm Monjuvi’s Efficacy in Large B-Cell Lymphoma

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