A new paper has been published recently in the magazine Nature which explores short-lasting intermittent fasting in lung cancer with very promising results in substantially improving the response to treatment with an inhibitory check point in tumours where it was carried out with 24 or 48 hour fasting compared to none.
There are data on how caloric restriction improves survival and has preventive effects against cancer (1); there is also pre-clinical information on the effect of fasting in improving the side effects of chemotherapy and delaying tumour progression effects mediated by the anti-tumour effect associated with the changes that occur in the cells of the immune system in the tumour environment with this fasting.
In this study, the inhibition of the IGF-1/IGF-1R axis is related to the increased activity of anti-PD1-PDL1 antibodies against lung cancer and related to the decrease of Treg lymphocytes and increase of CD8 T cells, which has been associated with immunosuppression and may restore the immune activity against the tumour. This could therefore represent a new target in the context of immune therapy with anti-PD-1 and a possible marker of this to be explored.
Until now the relationship of IGF-1R with the evolution of lung cancer was known. Clinical trials with antagonists associated with chemotherapy have not improved survival in patients with advanced lung cancer but there are no clinical data associated with immunotherapy.
The growing use of immunotherapy in cancer is the greatest advance in decades, and especially in lung cancer, although not all patients benefit from these drugs, which poses a challenge for research into resistance mechanisms and how to extrapolate results to patients. This preclinical study provides a line to be explored in patients with a recognised molecular basis.
- Willcox, B. J. et al. Caloric restriction, the traditional Okinawan diet, and healthy aging: the diet of the world’s longest-lived people and its potential impact on morbidity and life span. Ann. NY Acad. Sci. 1114, 434–455 (2007).
Dr Pilar López Criado, Head of Section for Lung, Head and Neck Tumours and Melanoma.