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Intermittent Fasting Primes the Tumor Microenvironment and Improves Nanomedicine Delivery in Hepatocellular Carcinoma
Authors:Svea Becker  Jeffrey Momoh  Ilaria Biancacci  Diana Möckel  Qingbi Wang  Jan-Niklas May  Huan Su  Lena Susanna Candels  Marie-Luise Berres  Fabian Kiessling  Maximilian Hatting  Twan Lammers  Christian Trautwein
Affiliation:1. Clinic for Gastroenterology, Metabolic Disorders, and Internal Intensive Medicine (Med III), University Hospital RWTH Aachen, 52074 Aachen, Germany

Institute for Experimental Molecular Imaging (ExMI), University Hospital RWTH Aachen, 52074 Aachen, Germany;2. Institute for Experimental Molecular Imaging (ExMI), University Hospital RWTH Aachen, 52074 Aachen, Germany;3. Clinic for Gastroenterology, Metabolic Disorders, and Internal Intensive Medicine (Med III), University Hospital RWTH Aachen, 52074 Aachen, Germany

Abstract:Fasting has many health benefits, including reduced chemotherapy toxicity and improved efficacy. It is unclear how fasting affects the tumor microenvironment (TME) and tumor-targeted drug delivery. Here the effects of intermittent (IF) and short-term (STF) fasting are investigated on tumor growth, TME composition, and liposome delivery in allogeneic hepatocellular carcinoma (HCC) mouse models. To this end, mice are inoculated either subcutaneously or intrahepatically with Hep-55.1C cells and subjected to IF for 24 d or to STF for 1 d. IF but not STF significantly slows down tumor growth. IF increases tumor vascularization and decreases collagen density, resulting in improved liposome delivery. In vitro, fasting furthermore promotes the tumor cell uptake of liposomes. These results demonstrate that IF shapes the TME in HCC towards enhanced drug delivery. Finally, when combining IF with liposomal doxorubicin treatment, the antitumor efficacy of nanochemotherapy is found to be increased, while systemic side effects are reduced. Altogether, these findings exemplify that the beneficial effects of fasting on anticancer therapy outcomes go beyond modulating metabolism at the molecular level.
Keywords:cancer  chemotherapy  drug delivery  fasting  hepatocellular carcinoma  nanomedicine
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