Fasting protects against the side effects of irinotecan but preserves its anti-tumor effect in Apc15lox mutant mice

Sander Huisman, W Bijman-Lagcher, J.N.M. IJzermans, Ron Smits, Ron de Bruin

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Abstract

Irinotecan is a widely used topoisomerase-I-inhibitor with a very narrow therapeutic window because of its severe toxicity. In the current study we have examined the effects of fasting prior to irinotecan treatment on toxicity and anti-tumor activity. FabplCre;Apc(15lox/+) mice, which spontaneously develop intestinal tumors, of 27weeks of age were randomized into 3-day fasted and ad libitum fed groups, followed by treatment with a flat-fixed high dose of irinotecan or vehicle. Side-effects were recorded until 11days after the start of the experiment. Tumor size, and markers for cell-cycle activity, proliferation, angiogenesis, and senescence were measured. Fasted mice were protected against the side-effects of irinotecan treatment. Ad libitum fed mice developed visible signs of discomfort including weight loss, lower activity, ruffled coat, hunched-back posture, diarrhea, and leukopenia. Irinotecan reduced tumor size in fasted and ad libitum fed groups similarly compared to untreated controls (2.4 +/- 0.67mm and 2.4 +/- 0.82mm versus 3.0 +/- 1.05mm and 2.8 +/- 1.08mm respectively, P < 0.001). Immunohistochemical analysis showed reduced proliferation, a reduced number of vascular endothelial cells, and increased levels of senescence in tumors of both irinotecan treated groups. In conclusion, 3days of fasting protects against the toxic side-effects of irinotecan in a clinically relevant mouse model of spontaneously developing colorectal cancer without affecting its anti-tumor activity. These results support fasting as a powerful way to improve treatment of colorectal carcinoma patients.
Original languageUndefined/Unknown
Pages (from-to)2333-2339
Number of pages7
JournalCell Cycle
Volume14
Issue number14
DOIs
Publication statusPublished - 2015

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  • EMC MM-04-47-07

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