Bendykowska Maria, Gromadzka Grażyna
Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Woycickiego Street 1/3, 01-938 Warsaw, Poland.
Department of Biomedical Sciences, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Woycickiego Street 1/3, 01-938 Warsaw, Poland.
Diagnostics (Basel). 2025 Sep 18;15(18):2369. doi: 10.3390/diagnostics15182369.
Intermittent fasting (IF) is emerging as a promising non-pharmacological intervention in oncology, with the potential to modulate key biological processes including metabolic reprogramming, inflammation, autophagy, and immune function, particularly through the PI3K/AKT/mTOR pathway. However, translating IF into clinical practice requires robust tools to monitor its biological impact and therapeutic effectiveness. This narrative review aims to present and critically evaluate current diagnostic and monitoring strategies that can support the safe and effective integration of IF into oncological care. Methods: A comprehensive literature search was conducted across PubMed/Medline, Science Direct, Scopus, Wiley Online Library, and Google Scholar using a combination of free-text and MeSH terms related to intermittent fasting, oncology, biomarkers, immunophenotyping, metabolic pathways, gut microbiome, and diagnostic imaging. Two principal categories of monitoring objectives were identified. The first-mechanistic monitoring-focuses on elucidating IF-induced biological effects, including modulation of insulin/IGF-1 signaling, oxidative stress reduction, autophagy activation, immune reprogramming, and microbiome alterations. Advanced research tools such as single-cell RNA sequencing, proteomics, metabolomics, and circulating tumor DNA (ctDNA) assays offer high-resolution insights but currently remain limited to preclinical or translational settings due to cost and complexity. The second-clinical response monitoring-assesses IF's impact on treatment outcomes, including chemotherapy and immunotherapy response, toxicity reduction, tumor dynamics, and maintenance of nutritional and functional status. This requires clinically validated, accessible, and interpretable diagnostic tools. A dual-layered monitoring framework that integrates both mechanistic insights and clinical applicability is essential for the personalized implementation of IF in oncology. Although preliminary findings are promising, large-scale randomized trials with standardized protocols are necessary to confirm the efficacy, safety, and feasibility of IF in routine oncological care. The integration of IF with modern diagnostics may ultimately contribute to a more individualized, biologically informed cancer treatment paradigm.
间歇性禁食（IF）正在成为肿瘤学中一种有前景的非药物干预措施，尤其通过PI3K/AKT/mTOR途径，具有调节包括代谢重编程、炎症、自噬和免疫功能在内的关键生物学过程的潜力。然而，将间歇性禁食应用于临床实践需要强大的工具来监测其生物学影响和治疗效果。本叙述性综述旨在介绍并批判性评估当前的诊断和监测策略，这些策略可支持将间歇性禁食安全有效地整合到肿瘤护理中。方法：在PubMed/Medline、Science Direct、Scopus、Wiley Online Library和Google Scholar上进行了全面的文献检索，使用了与间歇性禁食、肿瘤学、生物标志物、免疫表型分析、代谢途径、肠道微生物群和诊断成像相关的自由文本和医学主题词的组合。确定了两类主要的监测目标。第一类——机制监测——专注于阐明间歇性禁食诱导的生物学效应，包括胰岛素/IGF-1信号传导的调节、氧化应激的降低、自噬的激活、免疫重编程和微生物群的改变。诸如单细胞RNA测序、蛋白质组学、代谢组学和循环肿瘤DNA（ctDNA）检测等先进研究工具提供了高分辨率的见解，但由于成本和复杂性，目前仍仅限于临床前或转化研究环境。第二类——临床反应监测——评估间歇性禁食对治疗结果的影响，包括化疗和免疫治疗反应、毒性降低、肿瘤动态以及营养和功能状态的维持。这需要经过临床验证、易于获得且可解释的诊断工具。一个整合了机制见解和临床适用性的双层监测框架对于在肿瘤学中个性化实施间歇性禁食至关重要。尽管初步研究结果很有前景，但需要进行具有标准化方案的大规模随机试验，以确认间歇性禁食在常规肿瘤护理中的疗效、安全性和可行性。将间歇性禁食与现代诊断方法相结合，最终可能有助于形成一种更个性化、基于生物学的癌症治疗模式。
