How Far Are We from Prescribing Fasting As Anticancer Medicine?

Overview

Journal Int J Mol Sci

Publisher MDPI

Specialties Biochemistry
Chemistry
Molecular Biology

Date 2020 Dec 4

PMID 33271979

Citations 14

Authors

Maria V Deligiorgi

Charis Liapi

Dimitrios T Trafalis

Affiliations

Soon will be listed here.

Abstract

(1) Background: the present review provides a comprehensive and up-to date overview of the potential exploitation of fasting as an anticancer strategy. The rationale for this concept is that fasting elicits a differential stress response in the setting of unfavorable conditions, empowering the survival of normal cells, while killing cancer cells. (2) Methods: the present narrative review presents the basic aspects of the hormonal, molecular, and cellular response to fasting, focusing on the interrelationship of fasting with oxidative stress. It also presents nonclinical and clinical evidence concerning the implementation of fasting as adjuvant to chemotherapy, highlighting current challenges and future perspectives. (3) Results: there is ample nonclinical evidence indicating that fasting can mitigate the toxicity of chemotherapy and/or increase the efficacy of chemotherapy. The relevant clinical research is encouraging, albeit still in its infancy. The path forward for implementing fasting in oncology is a personalized approach, entailing counteraction of current challenges, including: (i) patient selection; (ii) fasting patterns; (iii) timeline of fasting and refeeding; (iv) validation of biomarkers for assessment of fasting; and (v) establishment of protocols for patients' monitoring. (4) Conclusion: prescribing fasting as anticancer medicine may not be far away if large randomized clinical trials consolidate its safety and efficacy.

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References

Pietrocola F, Pol J, Vacchelli E, Baracco E, Levesque S, Castoldi F . Autophagy induction for the treatment of cancer. Autophagy. 2016; 12(10):1962-1964. PMC: 5079541. DOI: 10.1080/15548627.2016.1214778. View

Brandhorst S, Choi I, Wei M, Cheng C, Sedrakyan S, Navarrete G . A Periodic Diet that Mimics Fasting Promotes Multi-System Regeneration, Enhanced Cognitive Performance, and Healthspan. Cell Metab. 2015; 22(1):86-99. PMC: 4509734. DOI: 10.1016/j.cmet.2015.05.012. View

Colman R, Anderson R, Johnson S, Kastman E, Kosmatka K, Beasley T . Caloric restriction delays disease onset and mortality in rhesus monkeys. Science. 2009; 325(5937):201-4. PMC: 2812811. DOI: 10.1126/science.1173635. View

Yu D, Yang S, Miller B, Wisinski J, Sherman D, Brinkman J . Short-term methionine deprivation improves metabolic health via sexually dimorphic, mTORC1-independent mechanisms. FASEB J. 2018; 32(6):3471-3482. PMC: 5956241. DOI: 10.1096/fj.201701211R. View

Brandhorst S, Wei M, Hwang S, Morgan T, Longo V . Short-term calorie and protein restriction provide partial protection from chemotoxicity but do not delay glioma progression. Exp Gerontol. 2013; 48(10):1120-8. PMC: 3762887. DOI: 10.1016/j.exger.2013.02.016. View

Harman D . Aging: a theory based on free radical and radiation chemistry. J Gerontol. 1956; 11(3):298-300. DOI: 10.1093/geronj/11.3.298. View

Klement R, Champ C, Otto C, Kammerer U . Anti-Tumor Effects of Ketogenic Diets in Mice: A Meta-Analysis. PLoS One. 2016; 11(5):e0155050. PMC: 4861343. DOI: 10.1371/journal.pone.0155050. View

Braun F, Bertin-Ciftci J, Gallouet A, Millour J, Juin P . Serum-nutrient starvation induces cell death mediated by Bax and Puma that is counteracted by p21 and unmasked by Bcl-x(L) inhibition. PLoS One. 2011; 6(8):e23577. PMC: 3160893. DOI: 10.1371/journal.pone.0023577. View

Patra K, Hay N . The pentose phosphate pathway and cancer. Trends Biochem Sci. 2014; 39(8):347-54. PMC: 4329227. DOI: 10.1016/j.tibs.2014.06.005. View

10.

Lu Z, Xie J, Wu G, Shen J, Collins R, Chen W . Fasting selectively blocks development of acute lymphoblastic leukemia via leptin-receptor upregulation. Nat Med. 2016; 23(1):79-90. PMC: 6956990. DOI: 10.1038/nm.4252. View

11.

Shi Y, Felley-Bosco E, Marti T, Orlowski K, Pruschy M, Stahel R . Starvation-induced activation of ATM/Chk2/p53 signaling sensitizes cancer cells to cisplatin. BMC Cancer. 2012; 12:571. PMC: 3527202. DOI: 10.1186/1471-2407-12-571. View

12.

Fontana L, Klein S . Aging, adiposity, and calorie restriction. JAMA. 2007; 297(9):986-94. DOI: 10.1001/jama.297.9.986. View

13.

Yu Z, Mattson M . Dietary restriction and 2-deoxyglucose administration reduce focal ischemic brain damage and improve behavioral outcome: evidence for a preconditioning mechanism. J Neurosci Res. 1999; 57(6):830-9. View

14.

McDonald R, Ramsey J . Honoring Clive McCay and 75 years of calorie restriction research. J Nutr. 2010; 140(7):1205-10. PMC: 2884327. DOI: 10.3945/jn.110.122804. View

15.

Swindell W . Gene expression profiling of long-lived dwarf mice: longevity-associated genes and relationships with diet, gender and aging. BMC Genomics. 2007; 8:353. PMC: 2094713. DOI: 10.1186/1471-2164-8-353. View

16.

Bauersfeld S, Kessler C, Wischnewsky M, Jaensch A, Steckhan N, Stange R . The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study. BMC Cancer. 2018; 18(1):476. PMC: 5921787. DOI: 10.1186/s12885-018-4353-2. View

17.

Rebucci M, Michiels C . Molecular aspects of cancer cell resistance to chemotherapy. Biochem Pharmacol. 2013; 85(9):1219-26. DOI: 10.1016/j.bcp.2013.02.017. View

18.

Pietrocola F, Pol J, Vacchelli E, Rao S, Enot D, Baracco E . Caloric Restriction Mimetics Enhance Anticancer Immunosurveillance. Cancer Cell. 2016; 30(1):147-160. PMC: 5715805. DOI: 10.1016/j.ccell.2016.05.016. View

19.

Luqmani Y . Mechanisms of drug resistance in cancer chemotherapy. Med Princ Pract. 2005; 14 Suppl 1:35-48. DOI: 10.1159/000086183. View

20.

Poljsak B . Strategies for reducing or preventing the generation of oxidative stress. Oxid Med Cell Longev. 2011; 2011:194586. PMC: 3236599. DOI: 10.1155/2011/194586. View