Abstract
Simple SummaryStimulating our body’s own immune response to fight cancer is important for the success of cancer treatment in general. To further improve current cancer therapy, preclinical research shows that short-term fasting diets enhance cancer therapy efficacy, such as chemotherapy. Short-term fasting diets are low-caloric and low in protein for 3–5 days; they are usually done every couple of weeks. This review summarizes preclinical and clinical evidence of fasting diets synergizing with cancer therapy by boosting antitumor immunity.Short-term fasting (STF), using a low caloric, low protein fasting mimicking diet (FMD), appears to be a promising strategy to enhance chemotherapy-based cancer efficacy, while potentially alleviating toxicity. Preclinical results suggest that enhanced tumor immunity and decreased growth signaling, via lowering of circulating insulin and insulin growth factor 1 (IGF-1) levels form the potential underlying mechanisms. STF may boost anti-tumor responses by promoting tumor immunogenicity and decreasing local immunosuppression. These findings warrant further studies focused on the combination of STF, not only with chemotherapy, but also with immunotherapy to evaluate the full range of benefits of STF in cancer treatment. Here, we delineate the underlying anticancer mechanisms of fasting. We summarize preclinical evidence of STF boosting antitumor immunity and alleviating immunosuppression, as well as the clinical findings reporting the immunomodulatory effects of STF during various cancer treatments, including immunotherapy.
Highlights
The nature of the local immune response is strongly associated with the success of different cancer treatments [1,2]
In pre-clinical models, Short-term fasting (STF) can support antitumor immunity by increasing immunogenicity and relieving immunosuppression. This evidence warrants clinical trials investigating the combination of fasting or STF with chemoimmunotherapy and other cancer treatment modalities, examining STF effects on the immune system
Preclinical evidence shows that STF can reduce adverse events and improve the antitumor effects of chemotherapy
Summary
The nature of the local immune response is strongly associated with the success of different cancer treatments [1,2]. Pre-clinical studies have well established the benefits of adding fasting to cancer therapy [5]. These include the protection of healthy cells from chemotoxicity, while sensitizing tumor cells to chemotherapy at the same time, resulting in delayed progression [3,5,6]. An increasing number of clinical trials provide evidence for benefits of STF in the treatment of cancer, including the reduction of chemotoxicity [6–9]. The anticancer effects of fasting were attributed to improved antitumor immunity [3,4,10,11]. These findings suggest that fasting can reinforce the antitumor response when combined with chemotherapy, and encourage further exploration of combinations with other treatments, immunotherapy for instance
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