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. 2023 Nov 4;15(21):4677.
doi: 10.3390/nu15214677.

Impact of Caloric Restriction in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy: A Prospective Case Control Study

Isabella Castellano  1 , Francesco Gallo  2 , Paola Durelli  2 , Taira Monge  2 , Maurizio Fadda  2 , Jasna Metovic  1 , Paola Cassoni  1 , Fulvio Borella  3 , Carlo Raucci  4 , Monica Menischetti  4 , Alessandra Beano  5 , Giuseppe Migliaretti  6 , Concetta Finocchiaro  2
Affiliations

Impact of Caloric Restriction in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy: A Prospective Case Control Study

Isabella Castellano et al. Nutrients. .

Abstract

Background and aims: It is well established that caloric restriction (CR) may influence metabolic and hormonal factors involved in cancer development and progression. Recently, several studies have demonstrated that CR may have a favorable impact on the response to systemic therapy in breast cancer (BC) patients. However, there is a lack of data regarding the influence of CR during neoadjuvant chemotherapy (NACT). Our study's primary aim was to evaluate CR's impact on BC patients undergoing NACT. Secondly, we investigated the nutritional efficacy and safety of this intervention. Methods: We performed a prospective, case-control study in two breast units. A diet group consisting of 39 patients undergoing NACT and CR was enrolled in our study at the same time. CR consisted of a 30% reduction in caloric intake, which increased to 50% on the days before, during, and after the administration of chemotherapy. A control group of 60 patients that underwent the same treatment approach only followed the general dietary recommendations for BC according to WCRF guidelines. The diet group was monitored during the study for both dietary adequacy and weight trends. Results: CR combined with NACT showed a statistically significant therapeutic response in tumor size (OR 2.94, IC 1.07-8.01, p = 0.009) and lymph node status (OR 3.22, IC 1.22-8.56, p = 0.001) compared to NACT alone, even after the adjustment for all biological parameters. Our data also showed the efficacy and safety of this intervention in both anthropometric and biochemical analyses. Conclusions: Patients who adhered to CR showed a better response to NACT, both in the breast and in the axillary lymph nodes, compared to the patients in the control group. Furthermore, the CR diet combined with NACT showed good tolerance and safety.

Keywords: body composition; breast cancer; caloric restriction diet; diet; neoadjuvant chemotherapy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
(A,B) Different caloric intake distributions in the two moments of caloric restriction.
Figure 2
Figure 2
Two groups of patients under treatment with caloric restriction and standard diet.
See this image and copyright information in PMC

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