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

Author:

Castellano Isabella1,Gallo Francesco2,Durelli Paola2,Monge Taira2,Fadda Maurizio2ORCID,Metovic Jasna1ORCID,Cassoni Paola1ORCID,Borella Fulvio3ORCID,Raucci Carlo4,Menischetti Monica4,Beano Alessandra5,Migliaretti Giuseppe6,Finocchiaro Concetta2

Affiliation:

1. Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy

2. Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy

3. Gynecology and Obstetrics 1U, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy

4. Oncology Unity, Cottolengo Hospital, 10152 Turin, Italy

5. Medical Breast Oncology Unit, Department of Oncology, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy

6. Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy

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.

Funder

Molinette Research Foundation and CRT (Savings Bank of Turin) Foundation

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

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