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Safety and feasibility of fasting in combination with platinum-based chemotherapy

BACKGROUND: Short-term starvation prior to chemotherapy administration protects mice against toxicity. We undertook dose-escalation of fasting prior to platinum-based chemotherapy to determine safety and feasibility in cancer patients. METHODS: 3 cohorts fasted before chemotherapy for 24, 48 and 72 ...

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Autores principales: Dorff, Tanya B., Groshen, Susan, Garcia, Agustin, Shah, Manali, Tsao-Wei, Denice, Pham, Huyen, Cheng, Chia-Wei, Brandhorst, Sebastian, Cohen, Pinchas, Wei, Min, Longo, Valter, Quinn, David I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901417/
https://www.ncbi.nlm.nih.gov/pubmed/27282289
http://dx.doi.org/10.1186/s12885-016-2370-6
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author Dorff, Tanya B.
Groshen, Susan
Garcia, Agustin
Shah, Manali
Tsao-Wei, Denice
Pham, Huyen
Cheng, Chia-Wei
Brandhorst, Sebastian
Cohen, Pinchas
Wei, Min
Longo, Valter
Quinn, David I.
author_facet Dorff, Tanya B.
Groshen, Susan
Garcia, Agustin
Shah, Manali
Tsao-Wei, Denice
Pham, Huyen
Cheng, Chia-Wei
Brandhorst, Sebastian
Cohen, Pinchas
Wei, Min
Longo, Valter
Quinn, David I.
author_sort Dorff, Tanya B.
collection PubMed
description BACKGROUND: Short-term starvation prior to chemotherapy administration protects mice against toxicity. We undertook dose-escalation of fasting prior to platinum-based chemotherapy to determine safety and feasibility in cancer patients. METHODS: 3 cohorts fasted before chemotherapy for 24, 48 and 72 h (divided as 48 pre-chemo and 24 post-chemo) and recorded all calories consumed. Feasibility was defined as ≥ 3/6 subjects in each cohort consuming ≤ 200 kcal per 24 h during the fast period without excess toxicity. Oxidative stress was evaluated in leukocytes using the COMET assay. Insulin, glucose, ketones, insulin-like growth factor-1 (IGF-1) and IGF binding proteins (IGFBPs) were measured as biomarkers of the fasting state. RESULTS: The median age of our 20 subjects was 61, and 85 % were women. Feasibility criteria were met. Fasting-related toxicities were limited to ≤ grade 2, most commonly fatigue, headache, and dizziness. The COMET assay indicated reduced DNA damage in leukocytes from subjects who fasted for ≥48 h (p = 0.08). There was a non-significant trend toward less grade 3 or 4 neutropenia in the 48 and 72 h cohorts compared to 24 h cohort (p = 0.17). IGF-1 levels decreased by 30, 33 and 8 % in the 24, 48 and 72 h fasting cohorts respectively after the first fasting period. CONCLUSION: Fasting for 72 h around chemotherapy administration is safe and feasible for cancer patients. Biomarkers such as IGF-1 may facilitate assessment of differences in chemotherapy toxicity in subgroups achieving the physiologic fasting state. An onging randomized trial is studying the effect of 72 h of fasting. TRIAL REGISTRATION: NCT00936364, registered propectively on July 9, 2009. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2370-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-49014172016-06-11 Safety and feasibility of fasting in combination with platinum-based chemotherapy Dorff, Tanya B. Groshen, Susan Garcia, Agustin Shah, Manali Tsao-Wei, Denice Pham, Huyen Cheng, Chia-Wei Brandhorst, Sebastian Cohen, Pinchas Wei, Min Longo, Valter Quinn, David I. BMC Cancer Research Article BACKGROUND: Short-term starvation prior to chemotherapy administration protects mice against toxicity. We undertook dose-escalation of fasting prior to platinum-based chemotherapy to determine safety and feasibility in cancer patients. METHODS: 3 cohorts fasted before chemotherapy for 24, 48 and 72 h (divided as 48 pre-chemo and 24 post-chemo) and recorded all calories consumed. Feasibility was defined as ≥ 3/6 subjects in each cohort consuming ≤ 200 kcal per 24 h during the fast period without excess toxicity. Oxidative stress was evaluated in leukocytes using the COMET assay. Insulin, glucose, ketones, insulin-like growth factor-1 (IGF-1) and IGF binding proteins (IGFBPs) were measured as biomarkers of the fasting state. RESULTS: The median age of our 20 subjects was 61, and 85 % were women. Feasibility criteria were met. Fasting-related toxicities were limited to ≤ grade 2, most commonly fatigue, headache, and dizziness. The COMET assay indicated reduced DNA damage in leukocytes from subjects who fasted for ≥48 h (p = 0.08). There was a non-significant trend toward less grade 3 or 4 neutropenia in the 48 and 72 h cohorts compared to 24 h cohort (p = 0.17). IGF-1 levels decreased by 30, 33 and 8 % in the 24, 48 and 72 h fasting cohorts respectively after the first fasting period. CONCLUSION: Fasting for 72 h around chemotherapy administration is safe and feasible for cancer patients. Biomarkers such as IGF-1 may facilitate assessment of differences in chemotherapy toxicity in subgroups achieving the physiologic fasting state. An onging randomized trial is studying the effect of 72 h of fasting. TRIAL REGISTRATION: NCT00936364, registered propectively on July 9, 2009. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12885-016-2370-6) contains supplementary material, which is available to authorized users. BioMed Central 2016-06-10 /pmc/articles/PMC4901417/ /pubmed/27282289 http://dx.doi.org/10.1186/s12885-016-2370-6 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Dorff, Tanya B.
Groshen, Susan
Garcia, Agustin
Shah, Manali
Tsao-Wei, Denice
Pham, Huyen
Cheng, Chia-Wei
Brandhorst, Sebastian
Cohen, Pinchas
Wei, Min
Longo, Valter
Quinn, David I.
Safety and feasibility of fasting in combination with platinum-based chemotherapy
title Safety and feasibility of fasting in combination with platinum-based chemotherapy
title_full Safety and feasibility of fasting in combination with platinum-based chemotherapy
title_fullStr Safety and feasibility of fasting in combination with platinum-based chemotherapy
title_full_unstemmed Safety and feasibility of fasting in combination with platinum-based chemotherapy
title_short Safety and feasibility of fasting in combination with platinum-based chemotherapy
title_sort safety and feasibility of fasting in combination with platinum-based chemotherapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901417/
https://www.ncbi.nlm.nih.gov/pubmed/27282289
http://dx.doi.org/10.1186/s12885-016-2370-6
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