Fasting and cancer: molecular mechanisms and clinical application
Open accessAbstract
The vulnerability of cancer cells to nutrient deprivation and their dependency on specific metabolites are emerging hallmarks of cancer. Fasting or fasting-mimicking diets (FMDs) lead to wide alterations in growth factors and in metabolite levels, generating environments that can reduce the capability of cancer cells to adapt and survive and thus improving the effects of cancer therapies. In addition, fasting or FMDs increase resistance to chemotherapy in normal but not cancer cells and promote regeneration in normal tissues, which could help prevent detrimental and potentially life-threatening side effects of treatments. While fasting is hardly tolerated by patients, both animal and clinical studies show that cycles of low-calorie FMDs are feasible and overall safe. Several clinical trials evaluating the effect of fasting or FMDs on treatment-emergent adverse events and on efficacy outcomes are ongoing. We propose that the combination of FMDs with chemotherapy, immunotherapy or other treatments represents a potentially promising strategy to increase treatment efficacy, prevent resistance acquisition and reduce side effects.
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Fasting can reprogram metabolic derangements to inhibit cancer growth.
“However, fasting could reprogram metabolic derangements to inhibit cancer growth8,29–31.”
From RETRACTED ARTICLE: Fasting inhibits aerobic glycolysis and proliferation in colorectal cancer via the Fdft1-mediated AKT/mTOR/HIF1α pathway suppression (2020) · cites this paper as [8]
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- Authors
- Nencioni, A., Caffa, I., Cortellino, S., & Longo, V. D.
- Affiliations
- Ospedale Policlinico San Martino (IT)
- University of Genoa (IT)
- IFOM (IT)
- University of Southern California (US)
- Corresponding author
- Longo, Valter D.
- Venue
- Nature Reviews Cancer
- Published
- 2018-10-16
- Volume
- 18
- Issue
- 11
- Pages
- 707-719
- ISSN
- 1474-175X (ISSN-L)
- 1474-1768
- PMC
- PMC6938162
- OpenAlex
- W2896280679
- Cited by
- 518
- References
- 149
- Citations by year
- 2026: 39 · 2025: 60 · 2024: 82 · 2023: 85 · 2022: 82 · 2021: 68 · 2020: 78 · 2019: 23
- FWCI
- 5.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature reviews. Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion, other-oa)
- Funders
- National Institute on Aging (P01AG034906, R01AG020642, P01AG055369)
- Topics
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- fasting, fasting-mimicking diet, cancer metabolism, nutrient deprivation, cancer cell vulnerability, chemoresistance, immunotherapy, treatment side effects, metabolic reprogramming, combination therapy
- MeSH terms
- Diet, Fasting, Humans, Neoplasms
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