Evidence map›Paper›PMID 28539118›Full record

ReviewBMC medicine2017

When less may be more: calorie restriction and response to cancer therapy.

Ciara H O'Flanagan, Laura A Smith, Shannon B McDonell, Stephen D Hursting

2 registry-linked trialsOpen access · goldAbstract readReview
In one paragraph

Review in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 114 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
114citing papers in PubMed, 3 pooled it
13.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04469296 narecruitingnot on this mapstarted 2021, after this paper: background citation

Trial Studying the Feasibility of a Diet Modification in pAtients With Luminal Early Breast Cancer Candidate for Primary Surgery

TypeinterventionalSponsorInstitut du Cancer de Montpellier - Val d'AurelleRan2021 to 2026Enrolled75ConditionsBreast Cancer, SurgeryArmsiso-caloric ketogenic diet, protein restricted diet
NCT05119010 naterminatednot on this mapstarted 2023, after this paper: background citation

A Pilot Study Evaluating a Ketogenic Diet Concomitant to Nivolumab and Ipilimumab in Patients With Metastatic Renal Cell Carcinoma

TypeinterventionalSponsorGustave Roussy, Cancer Campus, Grand ParisRan2023 to 2024Enrolled3ConditionsMetastatic Renal Cell CarcinomaArmsContinuous ketogenic diet, Discontinuous ketogenic diet, beta-hydroxybutyrate (BHB) supplementation
3 · Its place in the literature

Who cites it

114 citing papers in PubMed, 3 syntheses or guidelines pooled it, 196 citations in OpenAlex.

  1. Pooled it
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  7. Intermittent fasting enhances cancer therapyWorld journal of clinical oncology · 2026
    Review
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54 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Ciara H O'FlanaganDepartment of Nutrition, University of North Carolina, Chapel Hill, NC, 27517, USA.
Laura A SmithDepartment of Nutrition, University of North Carolina, Chapel Hill, NC, 27517, USA.
Shannon B McDonellDepartment of Nutrition, University of North Carolina, Chapel Hill, NC, 27517, USA.
Stephen D HurstingDepartment of Nutrition, University of North Carolina, Chapel Hill, NC, 27517, USA. hursting@email.unc.edu.
University of North Carolina at Chapel Hill · US

Funding

Virology Research Program (Program 4)P30CA016086 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Deborah F. Tate · 1985 to 2026
$201.5M
UNIV OF NORTH CAROLINA CLINICAL NUTRITION RESEARCH UNITP30DK056350 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SUSAN M. SMITH · 1999 to 2026
$31.6M
Higher Dietary Carbohydrates Detrimentally Impact Obesity-Associated Breast Cancer ChemoresistanceR35CA197627 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI HURSTING, STEPHEN D · 2015 to 2021
$6.0M
NCI NIH HHS P30 CA016086NCI NIH HHS R35 CA197627NIDDK NIH HHS P30 DK056350
6 · The paper itself

Abstract

Calorie restriction (CR) extends lifespan and has been shown to reduce age-related diseases including cancer, diabetes, and cardiovascular and neurodegenerative diseases in experimental models. Recent translational studies have tested the potential of CR or CR mimetics as adjuvant therapies to enhance the efficacy of chemotherapy, radiation therapy, and novel immunotherapies. Chronic CR is challenging to employ in cancer patients, and therefore intermittent fasting, CR mimetic drugs, or alternative diets (such as a ketogenic diet), may be more suitable. Intermittent fasting has been shown to enhance treatment with both chemotherapy and radiation therapy. CR and fasting elicit different responses in normal and cancer cells, and reduce certain side effects of cytotoxic therapy. Findings from preclinical studies of CR mimetic drugs and other dietary interventions, such as the ketogenic diet, are promising for improving the efficacy of anticancer therapies and reducing the side effects of cytotoxic treatments. Current and future clinical studies will inform on which cancers, and at which stage of the cancer process, CR, fasting, or CR mimetic regimens will prove most effective.

Indexed as

Caloric RestrictionAnimalsHumansNeoplasmsAutophagyCachexiaCalorie restrictionChemotherapyDrug resistanceFastingInsulin-like growth factor 1Ketogenic dietMetabolismRadiation therapy

Identifiers

PMID28539118
PMCPMC5442682
OpenAlexW2617439993

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.