Data continues to accumulate in favor of the fasting mimicking diet in breast cancer treatment. The latest comes from a study conducted by Valter Longo’s group at IFOM in Milan, published in Cell Reports: the fasting mimicking diet has enhanced – for now in laboratory animals – the effect of immunotherapy, reactivating the immune system. But patient studies are already underway.
What is the fasting mimicking diet
Fasting mimicking diet does not mean a real fast, but a specific clinical nutrition protocol, designed for cancer patients, with the aim of triggering metabolic changes in order to make cancer cells more sensitive to therapies and to minimize side effects. The fasting mimicking diet had already been tested in patients with breast cancer (and not only) in combination with chemotherapy: previous studies conducted by the same research group, which makes use of the collaboration with important cancer centers, had in fact shown both the feasibility of following this type of regimen is likely to be effective.
Fasting-mimicking diet and metformin against the most aggressive breast cancer
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Triple negative, immunotherapy and diet: the new study
At that time, the trial had already involved patients with triple negative breast cancer, that is the most difficult breast cancer to treat, which represents about 15-20% of cases and is so called due to the lack of all three specific markers for which there are targeted therapies (estrogen, progesterone and HER2). Today, for metastatic forms, treatment is based on immunotherapy, which however is not always effective. Hence the rationale and objective of the new study: to reactivate the antitumor immune response where resistance to immunotherapy is present and, at the same time, limit the side effects of the treatment, such as systemic inflammation.
Diet therapy against tumors: effective and well tolerated by patients
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Well, the results of the research – supported by the AIRC Foundation and carried out with the collaboration of IEO, IRCCS Foundation National Cancer Institute, San Raffaele Hospital and University of Palermo – showed that the metabolic, cellular and extracellular changes induced by the fasting mimicking diet remodel the tumor microenvironment, making it less immunosuppressive and promoting the reactivation of the immune system stimulated by immunotherapy drugs.
Two types of cells
“The experiments were conducted in laboratory animals in which two types of cells in culture of triple negative breast cancer resistant to immunotherapy were implanted”, explains Longo: the data collected show that the fasting mimicking diet increases the efficacy of the antitumor response even in resistant tumors, favoring the expansion of a subpopulation of the T cells of the immune system, which are reprogrammed and reactivated by immunotherapy.
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Can I do the fasting-mimicking diet?
The fasting mimicking diet sensitized both types of cancer cells to immunotherapy, but with different mechanisms. “The fasting mimicking diet seems to exert a different action on the different types of tumor cells evaluated, probably on the basis of their genetic and metabolic profile”, says Salvatore Cortellino, Ifom researcher and first author of the article: “The consequent antitumor immune response seems therefore it depends on the interactions with the tumor of the cells and defense molecules involved, and on the conditions of the tumor microenvironment “.
The next steps
In short, the conditions for expecting an enhancement of the response to immunotherapy are there, and now the researchers plan to test the approach in clinical trials. “The result is promising – concludes Longo -. Together with recent studies by Vernieri and colleagues at the National Cancer Institute in Milan, which showed strong changes in the immune system in cancer patients treated with the fasting mimicking diet, this could prove to be of great importance. If clinically validated in clinical trials with large case series, the identified strategy could be used against many types of cancer and could bring significant benefit to the therapy of many cancer patients, especially older ones and those undergoing multiple drugs that activate the immune system and which cause strong side effects “.