{"title":"Impact of intermittent fasting on patients with cancer undergoing chemotherapy and/or targeted therapies: a systematic review of the literature.","authors":"Juliette Maes, Valérie Durieux, Margaux Liebmann, Maurine Salmon, Jean-Charles Preiser","doi":"10.1007/s00520-025-09907-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Intermittent fasting holds potential for improving cancer patient outcomes by promoting cancer cell death. Additionally, it depletes hepatic glycogen reserves, facilitating the release of fatty acids and ketones, which may enhance cancer cells sensitivity to chemotherapy and impede their proliferation. However, clinical data on fasting among cancer patients remain scarce. This systematic review intends to provide an overview of the impact of intermittent fasting on the safety, feasibility, tolerability, and metabolic effects of chemotherapy and targeted therapies in cancer patients.</p><p><strong>Methods: </strong>Articles were retrieved from 1990 to March 2025, employing a defined search equation. Established endpoints included cancer development, treatment efficacy, side effects related to chemotherapy and targeted therapies, quality of life, and fasting tolerance. Risk of bias was assessed, utilizing a validated assessment tool.</p><p><strong>Results: </strong>Among 1,725 articles, nine met our inclusion criteria. Risk of bias was low to moderate. These studies included patients predominantly with breast cancer (n = 258/354). Even though the safety and feasibility of intermittent fasting were confirmed, no impact on treatment outcomes and chemotherapy-related toxicities was demonstrated. However, a consistent trend emerged in reduced insulin and IGF-1 levels, along with increased erythrocyte levels among fasting patients. Three studies reported no significant difference in body weight and BMI.</p><p><strong>Conclusion: </strong>Current evidence indicates that intermittent fasting is both safe and feasible. However, due to the lack of robust evidence, a definitive conclusion regarding the impact of intermittent fasting on treatment effectiveness and side effects related to chemotherapy and targeted therapies in cancer patients cannot be drawn. Larger randomized controlled trials are warranted to validate intermittent fasting as an adjunctive therapeutic approach.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 10","pages":"863"},"PeriodicalIF":3.0000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Supportive Care in Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00520-025-09907-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Intermittent fasting holds potential for improving cancer patient outcomes by promoting cancer cell death. Additionally, it depletes hepatic glycogen reserves, facilitating the release of fatty acids and ketones, which may enhance cancer cells sensitivity to chemotherapy and impede their proliferation. However, clinical data on fasting among cancer patients remain scarce. This systematic review intends to provide an overview of the impact of intermittent fasting on the safety, feasibility, tolerability, and metabolic effects of chemotherapy and targeted therapies in cancer patients.
Methods: Articles were retrieved from 1990 to March 2025, employing a defined search equation. Established endpoints included cancer development, treatment efficacy, side effects related to chemotherapy and targeted therapies, quality of life, and fasting tolerance. Risk of bias was assessed, utilizing a validated assessment tool.
Results: Among 1,725 articles, nine met our inclusion criteria. Risk of bias was low to moderate. These studies included patients predominantly with breast cancer (n = 258/354). Even though the safety and feasibility of intermittent fasting were confirmed, no impact on treatment outcomes and chemotherapy-related toxicities was demonstrated. However, a consistent trend emerged in reduced insulin and IGF-1 levels, along with increased erythrocyte levels among fasting patients. Three studies reported no significant difference in body weight and BMI.
Conclusion: Current evidence indicates that intermittent fasting is both safe and feasible. However, due to the lack of robust evidence, a definitive conclusion regarding the impact of intermittent fasting on treatment effectiveness and side effects related to chemotherapy and targeted therapies in cancer patients cannot be drawn. Larger randomized controlled trials are warranted to validate intermittent fasting as an adjunctive therapeutic approach.
期刊介绍：
Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease.
Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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