A lack of research on the effects of intermittent fasting on patients undergoing treatment for chronic myeloid leukemia (CML) with tyrosine kinase inhibitors (TKIs) inspired a team of researchers in Qatar to examine the potential in more detail. The results of their study are published in Cancer Control.
Because fasting is one of the central pillars of Islam, many Muslim patients with hematologic cancer fast during the holy month of Ramadan, regardless of the treatment they are undergoing. The researchers saw an opportunity to evaluate the effects of the fasting on their clinical progress, their hematologic parameters, and their BCR-ABL1 levels. They conducted a retrospective study that included information from 49 patients (27 Middle Eastern, 16 from the Indian subcontinent, and 6 Africans). Several different TKIs were used: 27 patients received imatinib, 15 received nilotinib, 8 received dasatinib, and 1 patient was treated with ponatinib.
The researchers noted that treating CML during intermittent fasting can be challenging because TKIs often have “distinctive pharmacokinetic properties in which some of these agents might interact with food and ultimately affect drug absorption.” They also considered the issue of drug compliance, since many people don’t always adhere to their treatment regimen when fasting.
“This study demonstrates that the use of TKIs during fasting did not result in significant changes in hematological indices or BCR-ABL1 levels,” the researchers wrote. “Patients who wish to practice intermittent [fasting] may be reassured in this regard. Yet, physicians can adopt the safe trial approach, where they allow the patients to fast, but with instructions regarding when and how to break fasting.”
Because this study was just a pilot study, the size and scope were limited. The researchers noted they hope to perform a multi-center study with a larger number of patients in the future. Additionally, this study only examined one type of intermittent fasting, and there are multiple types that could be explored.
Yassin MA, Ghasoub RS, Aldapt MB, et al. Effects of intermittent fasting on response to tyrosine kinase inhibitors (TKIs) in patients with chronic myeloid leukemia: an outcome of European LeukemiaNet Project. Cancer Control. April 20, 2021. doi:10.1177/10732748211009256