Ricerc@Sapienza

Fasting promotes changes in metabolic pathways and cellular processes as in the levels of plasma macro- and micro-nutrients, and consequently in glucose and growth factors with a reduction of glucose and IGF-1 levels. In cancer patients, fasting seems to have the potential of maximizing cancer cell sensitivity to antiblastic treatment with a phenomenon described as differential stress resistance: it seems to protect healthy cells against the adverse effects of chemotherapy while making tumor cells more vulnerable to it. Previous pilot studies have demonstrated that short fasting during neoadjuvant chemotherapy for different tumours is well tolerated and appears to improve quality of life. Scarce data have been reported about fasting and involved molecular pathways in ovarian cancer patients. Higher levels of IGF-1 are found to be associated with increased disease risk, tumour metastasis and poor prognosis in ovarian cancer but data still need to be confirmed.
Also the underlying biologic mechanisms of calorie restriction and fasting and tumorogenic/ anti-tumorogenic effects are not fully understood, but it has been shown to be associated with modulation of metabolic enzymes like adenosine monophosphate activated kinase (AMPK) and sirtuins family, which which have been found to be involved in the cell¿s stress adaption systems, cell metabolism and survival.

The aim of this study is to evaluate the role of short fasting during neoadjuvant chemotherapy in patients affected by advanced ovarian cancer, in particular we want to investigate its impact on metabolic and endocrine parameters including IGF-1 level; we¿ll also try to better correlate the effect of fasting with the SIRTUINs pathways,