Short-Term Fasting Before Chemotherapy in Treating Patients With Cancer

Inclusion

• Histologically confirmed malignancy
• Scheduled to undergo 4 or more cycles of chemotherapy (with or without past chemotherapy treatment)
• NOTE: Acceptable chemotherapy regimens are those that have all drugs infused on the first day of the chemotherapy cycle over a period =< 8 hours; EXCEPTION: Continuous 5-FU-containing regimens (such as FOLFOX6 and FOLFIRI) are allowed as both the 5-FU bolus as well as the oxaliplatin and irinotecan administration is completed on day 1 of chemotherapy
• Life expectancy of >= 168 days (6 months)
• ECOG performance status 0 or 1
• BMI > 21 kg/m^2
• Weight loss < 5% of body weight in the last 168 days (6 months)
• Adequate renal function (serum creatinine < 1.5 X UNL [upper normal limit] or creatinine clearance > 50 ml/min)
• Negative pregnancy test done =< 7 days prior to registration, for women of childbearing potential only
• Provide informed consent
• Ability to complete patient booklet by themselves or with assistance
• Ability and willingness to undergo >= 24-hour fast prior to chemotherapy
• Willingness to be treated at Mayo Clinic Rochester and be available for follow-up
• Patient willing to provide blood samples for correlative research purposes

Exclusion

• Any of the following: pregnant women; nursing women; men or women of childbearing potential who are unwilling to employ adequate contraception throughout the study period
• Diabetes mellitus undergoing therapy with insulin or oral agents
• History of low serum glucose (hypoglycemia) or insulinoma
• History of syncope with calorie restriction in the past or other medical comorbidity, which would make fasting potentially dangerous
• On daily medication that may not be safely taken without food; NOTE: Any non-essential medications and herbal/vitamin supplements should be held to minimize stomach upset during fasting; vitamin C use is discouraged
• Active gastric or duodenal peptic ulcer disease
• History of significant cardiac disease, particularly uncompensated congestive heart failure NYHA grade 2 or more or LVEF < 40% on any prior assessment; NOTE: Assessment of LVEF prior to therapy is not required in the absence of other clinical indicators of heart disease
• Recent history (< 6 months) of cerebrovascular accident or transient ischemic attacks
• History of gout or elevated uric acid level
• Psychiatric conditions that preclude adherence to study protocol
• Serious intercurrent infections or nonmalignant medical illnesses that are uncontrolled or whose control may potentially be jeopardized by the complications of fasting
• Patients receiving parenteral nutrition
• Receiving steroids (except dexamethasone given for nausea prevention before chemotherapy)
• Patients receiving taxotere-containing chemotherapy regimens requiring pre-treatment steroid administration
• Receiving concomitant treatment with IGF-receptor blockers or monoclonal antibodies targeting the IGF ligands
• Any of the following (prior to registration): =< 7 days from the time of a minor surgery; =< 21 days from the time of major surgery; =< 21 days from the time of radiation therapy
• Currently enrolled in a concomitant clinical trial