Department of Pharmacology-Clinical Pharmacology Unit, Faculty of Medicine, National and Kapodistrian University of Athens, 115 27 Goudi, Athens, Greece.
Int J Mol Sci. 2020 Dec 1;21(23):9175. doi: 10.3390/ijms21239175.
(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.
(1) 背景：本综述提供了一个关于将禁食作为抗癌策略的全面、最新的概述。这一概念的基本原理是，禁食在不利条件下引发了一种差异化的应激反应，使正常细胞得以存活，而杀死癌细胞。(2) 方法：本叙述性综述介绍了禁食对激素、分子和细胞的基本反应，重点关注禁食与氧化应激的相互关系。它还介绍了关于将禁食作为化疗辅助手段的非临床和临床证据，突出了当前的挑战和未来的前景。(3) 结果：有大量的非临床证据表明，禁食可以减轻化疗的毒性，或提高化疗的疗效。相关的临床研究令人鼓舞，尽管仍处于起步阶段。在肿瘤学中实施禁食的前进道路是一种个性化的方法，需要应对当前的挑战，包括：(i) 患者选择；(ii) 禁食模式；(iii) 禁食和再喂养的时间安排；(iv) 禁食评估生物标志物的验证；以及 (v) 为患者监测建立方案。(4) 结论：如果大型随机临床试验证实其安全性和疗效，那么将禁食作为抗癌药物可能指日可待。
