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Ni C, Li J. Take metabolic heterogeneity into consideration when applying dietary interventions to cancer therapy: A review. Heliyon 2023; 9:e22814. [PMID: 38213585 PMCID: PMC10782175 DOI: 10.1016/j.heliyon.2023.e22814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/13/2023] [Accepted: 11/20/2023] [Indexed: 01/13/2024] Open
Abstract
In recent years, dietary interventions have attracted much attention in cancer therapy. Mechanistic studies suggest that dietary interventions can inhibit the progression of cancer through deprivation of essential metabolites, lowering the levels of protumor hormones, activation of anticancer immunity and synergistic effects with conventional anticancer therapies. The feasibility, safety and promising tumor outcomes have also been established in humans. However, the results from both preclinical and clinical studies are inconsistent or even conflicting, the reasons for which have not been extensively considered. In this review, we discuss the various heterogeneity, including dietary protocols, tissue of origin and cancer locations, spatial and temporal metabolic heterogeneity, and divergent combination treatment, that may affect the responses of different cancers to dietary interventions. Understanding this heterogeneity and taking them into consideration when applying dietary interventions to cancer therapy will allow us to deliver the right diet to the right patient at the right time to maximize compliance, safety and efficacy of conventional anticancer therapy and to improve the outcomes of patients with cancer.
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Affiliation(s)
- Chun Ni
- Department of General Surgery, Chong Gang General Hospital, 400016, Chongqing, China
| | - Jian Li
- Department of General Surgery, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, China
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Ferro Y, Maurotti S, Tarsitano MG, Lodari O, Pujia R, Mazza E, Lascala L, Russo R, Pujia A, Montalcini T. Therapeutic Fasting in Reducing Chemotherapy Side Effects in Cancer Patients: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:2666. [PMID: 37375570 PMCID: PMC10303481 DOI: 10.3390/nu15122666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
The aim of this study was to assess the available evidence regarding the effect of a variety of fasting-like regimens on preventing chemotherapy-related side effects. PubMed, Scopus and Embase were used to select the studies for this review, which concluded on 24 November 2022. All types of clinical trials and case series reporting chemotherapy toxicity associated with fasting regimens and any comparison were considered. A total of 283 records were identified, of which 274 were excluded, leaving only nine studies that met the inclusion criteria. Five of these trials were randomized. Overall, moderate to high-quality evidence showed that several fasting regimens did not provide benefits compared to a conventional diet or other comparators in reducing the risk of adverse events. The overall pooled estimate for a variety of fasting regime when compared to non-fasting, indicated no significant difference in the side effects (RR = 1.10; 95% CI: 0.77-1.59; I2 = 10%, p = 0.60), including neutropenia alone (RR = 1.33; 95% CI: 0.90-1.97; I2 = 0%, p = 0.15). A sensitivity analysis confirmed these results. Based on our systematic review and meta-analysis, there is currently no evidence supporting the superiority of therapeutic fasting over non-fasting in preventing chemotherapy toxicity. The development of cancer treatment that do not entail toxicities remains imperative.
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Affiliation(s)
- Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (Y.F.); (M.G.T.); (R.P.); (R.R.); (A.P.)
| | - Samantha Maurotti
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy; (S.M.); (O.L.); (L.L.); (T.M.)
| | - Maria Grazia Tarsitano
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (Y.F.); (M.G.T.); (R.P.); (R.R.); (A.P.)
| | - Oscar Lodari
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy; (S.M.); (O.L.); (L.L.); (T.M.)
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (Y.F.); (M.G.T.); (R.P.); (R.R.); (A.P.)
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (Y.F.); (M.G.T.); (R.P.); (R.R.); (A.P.)
| | - Lidia Lascala
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy; (S.M.); (O.L.); (L.L.); (T.M.)
| | - Raffaella Russo
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (Y.F.); (M.G.T.); (R.P.); (R.R.); (A.P.)
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Grecia, 88100 Catanzaro, Italy; (Y.F.); (M.G.T.); (R.P.); (R.R.); (A.P.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100 Catanzaro, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy; (S.M.); (O.L.); (L.L.); (T.M.)
- Research Center for the Prevention and Treatment of Metabolic Diseases, University Magna Grecia, 88100 Catanzaro, Italy
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