Short-Term Fasting During Chemotherapy in Patients With Gynecological Cancer- a Randomized Controlled Cross-over Trial

NCT01954836 — Not applicable, Completed, 50 participants, Charite University, Berlin, Germany

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RegistryNCT01954836, acronym FIT
StatusCompleted
PhaseNot applicable
Study typeInterventional; randomized, crossover, masking: single, treatment
Enrollment50 (Actual)
SponsorCharite University, Berlin, Germany (Other)
ConditionsNeoplasia, Cancer, Fasting
Interventionsinitial fasting, Secondary fasting (Behavioral)
Datesstart 2013-10-01, primary completion 2015-03-01, completion 2015-03-01, first posted 2013-10-07, last updated 2016-12-13
Locations2 sites in Germany

Related Papers Related Patents Related Grants Related Experts
All trials for Neoplasia All trials for Cancer All trials of initial fasting All trials of Secondary fasting

-Summary

Hypothesis: Fasting before (48h) and one day after chemotherapy may protect normal cells from the adverse effects of chemotherapy. Design: Within a randomized controlled pilot trial 30 female patients with gynecological cancer (ovarian and breast cancer)and 4-6 scheduled chemotherapies will be randomized to fast 60-72 hours during the first half of chemotherapies or during the second half of chemotherapies and to proceed normocaloric food intake during the other cycles.Sequence of fasting and normocaloric food intake will be randomized. Assessments of adverse effects, quality of life and laboratory values take place 24 and 7 days after each chemotherapy. Statistical analyses compare summarized differences of fasted and non-fasted chemotherapy cycles.

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+Detailed description

Evidence from experimental animals provides strong support for the concept that caloric restriction (CR) increases resistance to multiple forms of stress. CR decreases plasma levels of growth factors, e.g. insulin-like growth factor-I (IGF-I), thereby diverting energy from growth to maintenance. Accordingly, the currently available information suggests that short-term fasting protects normal cells against the perils of (high dose) chemotherapy. In contrast, cancer cells are not (or less) protected as a result of their self-sufficiency in growth signals. This phenomenon is termed Differential Stress Resistance (DSR). DSR may reduce the severity of adverse effects caused by chemotherapy, without interfering with its anti-tumoral effects. A first case series of 10 cancer patients, suggested that short-term fasting may also protect against the side effects of chemotherapy in humans. This study aims to further evaluate the impact of short-term fasting on tolerance to chemotherapy in humans.Within a randomized controlled pilot trial 30 female patients with gynecological cancer disease (ovarian and breast cancer)in all stages and 4-6 scheduled chemotherapies will be randomized to fast 60-72 hours during half of chemotherapies and to have normocaloric food intake during the other chemotherapies. Fasting is defined as caloric restriction to below 400kcal energy intake/day with free intake of water and tea. Sequences of fasting and normocaloric food intake will be randomized. Assessments of adverse effects, quality of life, fatigue and laboratory values will take place 24 and 7 days after each chemotherapy. Statistical analyses will compare the summarized differences of fasted and non-fasted chemotherapy cycles, that means a total of max. 60-90 chemotherapies with accompanying fasting will be compared to 60-90 non-fasted chemotherapies.

+Arms and interventions

ArmTypeInterventionsDescription
Initial fastingExperimentalBehavioral: initial fastingFasting during chemotherapy of the first half of chemotherapy cycles (1 and 2 of four or 1 to 3 of six cycles)
Secondary fastingActive comparatorBehavioral: Secondary fastingFasting during the second half of chemotherapy cycles (3 and 4 of four cycles or 4 to 6 of six cycles)
  • initial fasting (Behavioral): modified fasting with daily caloric intake of <400kcal by juices starting 36 to 48 h before begin of chemotherapy and lasting to 24 h after end of chemotherapy applied in the first half of scheduled 4 or 6 chemotherapy cycles
  • Secondary fasting (Behavioral): modified fasting with daily caloric intake of <400kcal by juices starting 36 to 48 h before begin of chemotherapy and lasting to 24 h after end of chemotherapy applied in the second half of scheduled 4 or 6 chemotherapy cycles

+Outcome measures

Primary outcomes

  • Quality of life, modified FACT-O [24 h and 7 days after chemotherapy cycle]

Secondary outcomes

  • Fatigue [24 h and 7 days after chemotherapy cycle]
  • Intensity of adverse effects structured criteria Likert scales [24 h and 7 days after chemotherapy cycles]
  • Laboratory assessments (blood count, liver, renal function) [24 h and 7 days after chemotherapy cycles]

+Eligibility

Sex: Female, ages: 35 Years to 70 Years

Inclusion Criteria:

* Ovarian cancer or breast cancer
* scheduled chemotherapy
* First diagnosis or 1.recurrence

mono

Exclusion Criteria:

* cachexia (BMI < 21kg/m2)
* eating disorder
* renal failure (Crea >2mg/dl)
* enterostoma
* short bowel syndrome
* not assigned to other studies

+Locations (2)

FacilityCityCountryStatus
Charite UniversityBerlin, State of BerlinGermany
Charite UniversityBerlin, State of BerlinGermany

+Publications

  • Results publication: Bauersfeld SP, Kessler CS, Wischnewsky M, Jaensch A, Steckhan N, Stange R, Kunz B, Bruckner B, Sehouli J, Michalsen A. The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study. BMC Cancer. 2018 Apr 27;18(1):476. doi: 10.1186/s12885-018-4353-2. PMID 29699509

+Investigators

  • andreas A Michalsen, M.D., Principal investigator, Charite University