Cited by 518Dietary Effects on HealthCancer, Lipids, and MetabolismMetabolism, Diabetes, and Cancer

Fasting and cancer: molecular mechanisms and clinical application

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Nencioni, Alessio, Caffa, Irene, Cortellino, Salvatore, Longo, Valter D.·2018·Nature Reviews Cancer

Abstract

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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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
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
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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