创作:mildbreeze 审核:mildbreeze 06月24日
  • 纳入131名HER2阴性的二/三期乳腺癌患者,随机分为2组,在每个化疗周期前和治疗当天的4天内进行模拟禁食饮食(FMD)或常规饮食;
  • FMD组没有使用减轻化疗不良反应的地塞米松,但两组在治疗毒性方面无显著差异;
  • FMD可显著增强患者的治疗应答,与对照组相比,FMD组有更多的患者达到影像学(MRI或超声)的完全或部分缓解,以及癌细胞减少超过90%的病理应答,且依从性越高疗效越好;
  • FMD还减轻了化疗诱导的T细胞DNA损伤。
动物研究显示,短期的禁食或模拟禁食饮食(FMD)有助于改善癌症化疗的毒副作用,同时增强治疗的疗效。《Nature Communications》最新发表了首个评估FMD用于辅助癌症化疗的安全性和有效性的随机对照试验,表明FMD可有效增强化疗疗效,在减轻化疗毒副作用方面也有一定效果。禁食和FMD用于癌症治疗,值得进一步开展临床研究。

Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial



06-23, Article

Abstract & Authors:展开

Short-term fasting protects tumor-bearing mice against the toxic effects of chemotherapy while enhancing therapeutic efficacy. We randomized 131 patients with HER2-negative stage II/III breast cancer, without diabetes and a BMI over 18 kg m−2, to receive either a fasting mimicking diet (FMD) or their regular diet for 3 days prior to and during neoadjuvant chemotherapy. Here we show that there was no difference in toxicity between both groups, despite the fact that dexamethasone was omitted in the FMD group. A radiologically complete or partial response occurs more often in patients using the FMD (OR 3.168, P = 0.039). Moreover, per-protocol analysis reveals that the Miller&Payne 4/5 pathological response, indicating 90–100% tumor-cell loss, is more likely to occur in patients using the FMD (OR 4.109, P = 0.016). Also, the FMD significantly curtails chemotherapy-induced DNA damage in T-lymphocytes. These positive findings encourage further exploration of the benefits of fasting/FMD in cancer therapy. Trial number: NCT02126449.

First Authors:
Stefanie de Groot

Correspondence Authors:
Judith R Kroep

All Authors:
Stefanie de Groot,Rieneke T Lugtenberg,Danielle Cohen,Marij J P Welters,Ilina Ehsan,Maaike P G Vreeswijk,Vincent T H B M Smit,Hiltje de Graaf,Joan B Heijns,Johanneke E A Portielje,Agnes J van de Wouw,Alex L T Imholz,Lonneke W Kessels,Suzan Vrijaldenhoven,Arnold Baars,Elma Meershoek-Klein Kranenbarg,Marjolijn Duijm-de Carpentier,Hein Putter,Jacobus J M van der Hoeven,Johan W R Nortier,Valter D Longo,Hanno Pijl,Judith R Kroep,Dutch Breast Cancer Research Group (BOOG)