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Fasting-mimicking diets cut food intake for three days around each chemotherapy dose to lower glucose, insulin and IGF-1, which may shield normal cells and sensitise the tumour. The DIRECT trial in early breast cancer improved radiological response but fewer than 20% of patients kept to the diet, and it is unsafe in cachexia or without a dietitian.
Short-term fasting lowers glucose, insulin and IGF-1 and shifts normal cells into a protective, low-proliferation state ('differential stress resistance') while cancer cells, unable to slow down, may become more chemosensitive. Mouse data are strong. In humans, the DIRECT trial (Netherlands, 131 patients with HER2-negative early breast cancer, Nature Communications 2020) randomised a plant-based fasting-mimicking diet for three days before and on the day of each neoadjuvant chemotherapy cycle: radiological response was better (OR 3.2) and a 90-100% tumour cell loss more frequent in the diet arm, but adherence collapsed (fewer than 20% completed all cycles) and pathological complete response did not differ. Phase 2 trials in breast, colorectal and lung cancer are running; none has a survival endpoint yet. Weight loss and sarcopenia are real risks, and fasting is contraindicated in cachexia.
Nutrient deprivation lowers systemic growth signalling (insulin, IGF-1) and induces protective stress responses in normal tissue, potentially widening the therapeutic window of cytotoxics.
Query for this technology: (TITLE:"Fasting and fasting-mimicking diets around chemotherapy" OR ABSTRACT:"Fasting and fasting-mimicking diets around chemotherapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Fasting and fasting-mimicking diets around chemotherapy, not a curated reading list.
Shares Warburg-effect diet claims ('sugar feeds cancer'), Metabolic therapy: starving the tumour of a nutrient, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, PI3K / AKT / mTOR.
Shares Energy balance, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, PI3K / AKT / mTOR, Colorectal cancer.
Shares Warburg-effect diet claims ('sugar feeds cancer'), Metabolic therapy: starving the tumour of a nutrient, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment.
Shares Warburg-effect diet claims ('sugar feeds cancer'), Energy balance, Colorectal cancer.
Shares Energy balance, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Warburg-effect diet claims ('sugar feeds cancer'), Metabolic therapy: starving the tumour of a nutrient, Funding follows fashion, not burden.
Shares Energy balance, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, HR-positive / HER2-negative breast cancer, Colorectal cancer.
Shares No incentive to repurpose cheap drugs, HR-positive / HER2-negative breast cancer, Colorectal cancer.