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Do Fasting, CR and FMD Improve the Chemotherapy Response, Reduce Off-Target Toxicities and Enhance Antitumour Immunity? Illusion or Clinical Reality?

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Dietary Research and Cancer

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Abstract

Besides the great strides of efforts made towards understanding the effect of fasting, calorie restriction (CR) and fasting-mimicking diet (FMD), yet there is growing curiosity among the cancer survivors towards this unresolved question whether fasting/CR/FMD has any role to play in the progression and treatment of cancer. Few notable questions being asked by the cancer patients pertain to efficacy of fasting/CR/FMD in arresting the progression of cancer, killing of cancer cells, boosting of the immune system, and whether it has role in improving the effectiveness of currently prescribed chemotherapy and radiation therapy? The sensitivity of cancer cells towards nutrient depletion and their dependency on alternate metabolites has been emerged as a hallmark of cancer. The current preclinical and clinical research finding has demonstrated that fasting, calorie restriction or fasting-mimicking diets induce variety of alterations in growth factors, levels of metabolites, etc., which ultimately leads into creation of an environments that has potential to reduce the adaptive abilities of cancer cells towards survival and thereby helps in improving the efficacy of cancer chemotherapy. Moreover, fasting/calorie restriction or FMDs have been reported to increase resistance towards chemotherapy drugs in normal cells; however, it is not found in cancer cells and thereby promote regeneration effects in normal cells. These dramatic effects of fasting/FMD may help in preventing the detrimental side effects of chemotherapy drugs. Although fasting cannot be tolerated by patients, however, the current preclinical and clinical studies demonstrated feasibility and safety of periodic fasting or FMDs. Taking into considerations the current literature, it is possible to integrate the periodic fasting or FMDs with chemotherapy, cancer immunotherapy or other cancer treatments, which may increase the therapeutic index of cancer treatments and circumvent the emerging resistance and side effects or off-target toxicities.

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Abbreviations

ACC1:

Acetyl-coenzyme A carboxylase 1

AFT-3:

AMP-dependent transcription factor

AKT:

Protein kinase B

CD:

Cluster of differentiation

CML:

Chronic myeloid leukaemia

COX-2:

Cyclooxygenase-2

CR:

Calorie restriction

ENT1:

Equilibrative nucleoside transporter 1

ET-1:

Endothelin 1

FMD:

Fasting-mimicking diet

FoxO1:

Forkhead transcription factor O class 1

FoxO3:

Forkhead transcription factor O class 3

H2AX:

H2A histone family member X

HER2:

Human epidermal growth factor receptor 2

HIF-1α:

Hypoxia-induced factor 1α

HORMAD1:

HORMA domain-containing protein 1

ICAM-1:

Intercellular adhesion molecule 1

IGF:

Insulin-like growth factor

KD:

Ketogenic diet

mCRPC:

Metastatic castration-resistant prostate cancer.

NF-κB:

Nuclear factor-kappa light-chain enhancer of activated B cells

NK:

Natural killer cells

NSCLC:

Non-small cell lung cancer

PD-1:

Programmed cell death protein 1

PI3K:

Phosphoinositide 3 kinase

PPAR-γ:

Peroxisome proliferator-activated receptor γ

PTEN:

Phosphatase and tensin homolog

RAS:

Rat sarcoma

SIRT1:

Sirtuin 1

TKI:

Tyrosine kinase inhibitor

TNBC:

Triple-negative breast cancer

ZEB1:

Zinc finger E-box-binding homeobox 1

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Authors and Affiliations

  1. Tumor Biology Laboratory, Department of Biotechnology, Savitribai Phule Pune University, Pune, Maharashtra, India

    Rajesh N. Gacche

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Gacche, R.N. (2021). Do Fasting, CR and FMD Improve the Chemotherapy Response, Reduce Off-Target Toxicities and Enhance Antitumour Immunity? Illusion or Clinical Reality?. In: Dietary Research and Cancer . Springer, Singapore. https://doi.org/10.1007/978-981-16-6050-4_16

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