The effects of short-term fasting on tolerance to (neo) adjuvant chemotherapy in HER2-negative breast cancer patients: a randomized pilot study

Background Preclinical evidence shows that short-term fasting (STF) protects healthy cells against side effects of chemotherapy and makes cancer cells more vulnerable to it. This pilot study examines the feasibility of STF and its effects on tolerance of chemotherapy in a homogeneous patient group w...

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Published in:BMC cancer Vol. 15; no. 1; p. 652
Main Authors: de Groot, Stefanie, Vreeswijk, Maaike PG, Welters, Marij JP, Gravesteijn, Gido, Boei, Jan JWA, Jochems, Anouk, Houtsma, Daniel, Putter, Hein, van der Hoeven, Jacobus JM, Nortier, Johan WR, Pijl, Hanno, Kroep, Judith R
Format: Journal Article
Language:English
Published: London BioMed Central 05.10.2015
BioMed Central Ltd
Springer Nature B.V
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biomarkers
Biomedical and Life Sciences
Biomedicine
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - metabolism
Breast Neoplasms - mortality
Breast Neoplasms - pathology
Calories
Cancer Research
Care and treatment
Chemotherapy
Cloning
Comparative analysis
Complications and side effects
DNA Damage
Fasting
Female
Growth factors
Health aspects
Health Promotion and Disease Prevention
Histones - metabolism
Human subjects
Humans
Insulin
Laboratories
Leukocytes, Mononuclear - metabolism
Medicine/Public Health
Metabolism
Middle Aged
Neoadjuvant Therapy
Neoplasm Grading
Neoplasm Staging
Oncology
Patients
Pilot Projects
Receptor, ErbB-2 - deficiency
Research Article
Surgical Oncology
Time Factors
Toxicity
Treatment Outcome
Chemotherapy
Toxicity
Early stage breast cancer
DNA damage
Short-term fasting
ISSN:1471-2407, 1471-2407
Online Access:Get full text
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Summary:Background Preclinical evidence shows that short-term fasting (STF) protects healthy cells against side effects of chemotherapy and makes cancer cells more vulnerable to it. This pilot study examines the feasibility of STF and its effects on tolerance of chemotherapy in a homogeneous patient group with early breast cancer (BC). Methods Eligible patients had HER2-negative, stage II/III BC. Women receiving (neo)-adjuvant TAC (docetaxel/doxorubicin/cyclophosphamide) were randomized to fast 24 h before and after commencing chemotherapy, or to eat according to the guidelines for healthy nutrition. Toxicity in the two groups was compared. Chemotherapy-induced DNA damage in peripheral blood mononuclear cells (PBMCs) was quantified by the level of γ-H2AX analyzed by flow cytometry. Results Thirteen patients were included of whom seven were randomized to the STF arm. STF was well tolerated. Mean erythrocyte- and thrombocyte counts 7 days post-chemotherapy were significantly higher ( P = 0.007, 95 % CI 0.106-0.638 and P = 0.00007, 95 % CI 38.7-104, respectively) in the STF group compared to the non-STF group. Non-hematological toxicity did not differ between the groups. Levels of γ-H2AX were significantly increased 30 min post-chemotherapy in CD45 + CD3- cells in non-STF, but not in STF patients. Conclusions STF during chemotherapy was well tolerated and reduced hematological toxicity of TAC in HER2-negative BC patients. Moreover, STF may reduce a transient increase in, and/or induce a faster recovery of DNA damage in PBMCs after chemotherapy. Larger studies, investigating a longer fasting period, are required to generate more insight into the possible benefits of STF during chemotherapy. Trial registration ClinicalTrials.gov: NCT01304251 , March 2011
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ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-015-1663-5