E-Book

E-Book 3rd Congress

  • The Role of Fasting-mimicking Diets in Triple-negative Breast Cancer: Molecular Mechanisms and Clinical Implications
  • Farhad Soleimani,1 Nasrin Karbasi Ravari,2 Mina Soleimani,3,*
    1. MD, Graduate of the Department of General Practice, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
    2. MD, Graduate of the Department of General Practice, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
    3. Department of Laboratory Science, Faculty of Paramedicine, Mashhad Medical Science, Islamic Azad University, Mashhad, Iran


  • Introduction: Breast cancer (BC) is the most common malignancy among women after non-melanoma skin neoplasms, which is increasing in most regions, especially in developing countries. The most immunogenic type is triple-negative breast cancer (TNBC), which is a malignancy with a relatively high mutation load and very aggressive, associated with poor patient survival. Although new therapeutic strategies, such as chemo-immunotherapy combinations, have significantly improved clinical outcomes, epidemiological studies have identified nutrition as essential in BC care. Also, overweight and obesity have been introduced as risk factors for the occurrence and worse prognosis of BC and TNBC, which have been considered necessary strategies in the direction of optimal body weight for prevention and help in treatment, and thus, strategies to achieve optimal body weight are essential for prevention and treatment. In this regard, alternative methods with the aim of anti-cancer, including fasting diets and diets with low and limited calories, low carbohydrates, and low protein, collectively called fasting-mimicking diets (FMDs), have been introduced as a promising therapeutic approach in BC patients.
  • Methods: A systematic search was conducted from 2020 to 2023 in scientific databases such as PubMed, Scopus, Google Scholar, and the World Health Organization (WHO) website. The purpose of this research was to investigate the relationship between the molecular biology of the FMD strategy and the immune environment and cancerous and healthy cells of patients with breast cancer, especially of the triple-negative type. Search terms included "fasting-mimicking diets" and "Triple-negative breast cancer".
  • Results: A fasting-mimicking diet can include approximately 50% fat, 40% carbohydrates, and 10% protein and provide between 50% and 90% calorie reduction per day while the body cannot detect that it is being fed. Considering that TNBC cells are susceptible to nutrient deficiency, it has been shown that Fasting/FMD changes the shape of the immune environment along with the antitumor effects of nutrient starvation in combination with standard chemotherapy and immunotherapy methods and improves the feasibility and tolerability of these treatments. FMD can protect healthy cells from chemotherapy by reducing the toxicities associated with chemotherapy and increasing the positive response to it. Furthermore, making tumor cells more susceptible to chemotherapy and slowing down their growth in the body leads to more prolonged cell survival. FMD significantly reduces tumor development in the body. On the other hand, with a significant reduction in blood glucose and insulin concentrations, it has also reduced TNBC cancer stem cells, which play an essential role in tumor resistance to standard treatments. Most importantly, FMD significantly reduces the immunosuppressive population of myeloid cells and regulatory T cells by altering systemic and intra-tumoral immunity associated with increased cytotoxic T lymphocytes, natural killer T cells (NKT), and memory T cells. It also reduces the occurrence of immune-related adverse events (irAEs) by preventing overactivation of the immune response. On the other hand, Fasting/FMD treatment methods have proven that normalizing blood vessels in disturbed tumors can lead to the effect of drugs such as nanoparticles on tumors. Reducing the level of adenosine triphosphate (ATP) in drug-resistant cells prevents drug release, which, as a result, leads to the progress of the treatment process.
  • Conclusion: Since the control of BC, especially its TNBC type, along with overweight and obesity, has become a public health issue for women worldwide due to its high morbidity and mortality, this study has shown that, based on the findings, FMD can be considered an alternative, safe and promising auxiliary approach along with drugs and other treatment methods to control and improve the care of breast cancer patients.
  • Keywords: Fasting-mimicking diets, Triple-negative breast cancer, Breast Cancer, and Chemotherapy.