Table 2.
Overview of clinical trials observing potential immunomodulatory effects of STF in cancer treatment.
| Author, Location | Human Participant | Treatment | Outcome |
|---|---|---|---|
| Safdie et al., 2009, USC, USA [9] | n = 10, with different malignancies | Variable, water-only fasting 48–140 h prior to and/or 5–56 h after | Fewer side effects (self-reported) |
| Dorff et al., 2016, USC, USA (NCT00936364) [66] | n = 20, with different malignancies | Platinum-based chemotherapy with 24, 48, or 72 h of water-only fasting | Reduced DNA damage in leukocytes; trend towards less grade 3 or 4 neutropenia |
| Bauersfeld et al., 2018, Charite University, Germany (NCT01954836) [65] | n = 34, women with gynecological cancer | Water-only fasting 60 h around chemotherapy administration | Higher QoL score association |
| de Groot et al. LUMC, the Netherlands (NCT01304251) [67] | n = 13, women with breast cancer (HER2-negative) | TAC CT and 48 h STF | Reduced DNA-damage in PBMCs |
| de Groot et al., 2020, LUMC, the Netherlands (NCT02126449) [8] | n = 131, women with breast cancer (HER2-negative) | Randomized 4-day FMD or regular diet around neoadjuvant CT, maximum of 8 cycles |
Increased rate of CR or PR in ITT; increased rate of pathological response per protocol; reduced DNA-damage in PBMCs; QoL non-significant improved in FMD arm; similar grade 3–4 toxicity between arms |
| Vernieri et al., 2022, University of Milan, Italy (NCT03340935, NCT03454282) [11] | n = 101, with different malignancies | 5-day FMD every 3–4 weeks | Reduction peripheral MDSCs (n = 38); boost CD4 and CD8 T cell peripheral; increased NK cytotoxic activity; intratumoral: ↑CD8 TIL, ↑DCs, ↑NKs; systemic increased IFNγ |
| Breast cancer subgroup (n = 18) | Intratumoral: ↑M1 macrophage |
USC University of Southern California, LUMC Leiden University Medical Center, HER2 human epidermal growth factor receptor 2, CT chemotherapy, QoL quality of life, TAC docetaxel/doxorubicin/cyclophosphamide, STF short-term fasting, PBMC peripheral blood mononuclear cell, CR complete response (radiological), PR partial response (radiological), MDSC myeloid derived suppressor cell, NK natural killer cell, DC dendritic cells, IFNγ interferon gamma.