Ketogenic Diets and their Therapeutic Potential on Breast Cancer: A Systemic Review

Abstract

Breast cancer remains a major cause of morbidity and mortality in women, and there is still a lack of complementary approaches to significantly improve the efficacy of standard therapies. For many kinds of cancers, the usual standard care is the combination of surgery, radiation, and chemotherapy. However, this standard therapy is not effective alone. Therefore, new approaches that increase therapeutic effectiveness are urgently needed. The ketogenic diet is a novel therapeutic approach for certain types of cancers, as indicated by several preclinical and clinical evidences. The ketogenic diet, which consists of a high-fat, low-carbohydrate diet with adequate protein, appears to sensitize most cancers to standard therapy by utilizing the reprogrammed metabolism of cancer cells, making it a promising candidate for adjuvant cancer treatment. The majority of preclinical and clinical studies argue that the use of a ketogenic diet in combination with standard therapies is based on its potential to improve the antitumor effects of conventional chemotherapy, its overall good safety and tolerability, and quality of life improvement. According to new evidence, a ketogenic diet lowers the level of glucose and insulin in the blood, which are necessary for tumor growth. Thus, the ketogenic diet has emerged as a potential treatment option for a variety of cancers, including breast cancer. Besides, implementation of a Ketogenic diet in the clinic could improve progression-free and overall survival for patients with breast cancer. This review summarizes the composition and metabolism of ketogenic diets and their potential mechanisms in breast carcinogenesis in addition to their therapeutic potential on breast cancer.

Keywords:

• ketogenic diet
• breast cancer
• adjuvant breast cancer therapy

Abbreviation

BMI, Body mass index; CHO, Carbohydrate; FBS, Fasting Blood sugar; FK, Fasting Ketosis; HBOT, Hyperbaric oxygen therapy; HDAC, Histone Deacetylase; HIF-1α, Hypoxia-inducible factor 1-alpha; IGF-1, Insulin-like growth factor-1; KD, Ketogenic diet; KD-R, Calorie Restricted Ketogenic Diets; KMT, Ketogenic metabolic therapy; MCT, Medium-Chain Triglyceride; NK, Nutritional Ketosis; OXPHOS, Oxidative Phosphorylation; PI3K, Phosphatidylinositol-3 Kinase; Ras, Rat sarcoma; ROS, Reactive Oxygen Species; TCA, Tricarboxylic Acid.

Data Sharing Statement

Supporting data is available from the corresponding author on reasonable request. 

Ethics Approval

Ethical approval is not applicable since the publication is based on the data that was previously published articles and not on its investigations.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.