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

BMC Cancer

Research Article

Hanno Pijl¹  Maaike PG Vreeswijk²  Gido Gravesteijn²  Jan JWA Boei²  Daniel Houtsma³  Anouk Jochems⁴  Judith R Kroep⁴  Stefanie de Groot⁴  Marij JP Welters⁴  Jacobus JM van der Hoeven⁴  Johan WR Nortier⁴  Hein Putter⁵ 

[1] Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands;Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands;Department of Internal Medicine, Haga Hospital, The Hague, The Netherlands;Department of Medical Oncology, Leiden University Medical Center, P.O. Box 9600, Albinusdreef 2, 2300, Leiden, RC, The Netherlands;Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands;

关键词: Early stage breast cancer;    Chemotherapy;    Short-term fasting;    Toxicity;    DNA damage;   

DOI  :  10.1186/s12885-015-1663-5

 received in 2015-02-04, accepted in 2015-09-28,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPreclinical 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).MethodsEligible 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.ResultsThirteen 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.ConclusionsSTF 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 registrationClinicalTrials.gov: NCT01304251, March 2011

【 授权许可】

CC BY   
© de Groot et al. 2015