I could see that 5 star tune having a benefit. If what I've read is true, the V10 in the E450 always operates in closed loop mode with 14.7 mixture. If allowed to go open loop with the tuner, the mixture could be richened to 13 to 1 or something with timing advanced. If it had a premium fuel option, even more advance would be possible. I could see significant amounts of added low end torque and less need to downshift. Additionally the tuner would be able to alter the shift strategy of the transmission to make it less hyper. All at your own risk of course.
I do not see benefit from high flow items like KN air filter. These generally only add a little power at the highest reaches of RPM.