https://jeccr.biomedcentral.com/articles/10.1186/s13046-019-1189-9

Abstract

Growing preclinical evidence shows that short-term fasting (STF) protects from toxicity while enhancing the efficacy of a variety of chemotherapeutic agents in the treatment of various tumour types. STF reinforces stress resistance of healthy cells, while tumor cells become even more sensitive to toxins, perhaps through shortage of nutrients to satisfy their needs in the context of high proliferation rates and/or loss of flexibility to respond to extreme circumstances. In humans, STF may be a feasible approach to enhance the efficacy and tolerability of chemotherapy. Clinical research evaluating the potential of STF is in its infancy. This review focuses on the molecular background, current knowledge and clinical trials evaluating the effects of STF in cancer treatment. Preliminary data show that STF is safe, but challenging in cancer patients receiving chemotherapy. Ongoing clinical trials need to unravel if STF can also diminish toxicity and increase efficacy of chemotherapeutic regimes in daily practice.

Background

Chronic caloric restriction reduces and delays cancer incidence, and inhibits tumor progression and metastasis in rodents [1,2,3,4,5]. Accordingly, cancer incidence and mortality are strongly reduced in chronic calorie restricted non-human primates [6]. Studies of long-term calorie restricted human subjects have shown a reduction of metabolic and hormonal factors associated with cancer risk [7,8,9]. However, chronic caloric restriction is not a feasible clinical intervention. Evident difficulties, such as the long period required to be effective, and unacceptable weight loss [10, 11], hamper clinical application in cancer patients.