Rationale and design of the Diet Restriction and Exercise-induced Adaptations in Metastatic breast cancer (DREAM) study: a 2-arm, parallel-group, phase II, randomized control trial of a short-term, calorie-restricted, and ketogenic diet plus exercise during intravenous chemotherapy versus usual care

• Published in: BMC cancer Vol. 21; no. 1; pp. 1093 - 14
• Main Authors: Kirkham, Amy A, King, Karen, Joy, Anil A, Pelletier, André B, Mackey, John R, Young, Kelvin, Zhu, Xiaofu, Meza-Junco, Judith, Basi, Sanraj K, Hiller, Julie Price, Brkin, Tina, Michalowski, Bonnie, Pituskin, Edith, Paterson, D Ian, Courneya, Kerry S, Thompson, Richard B, Prado, Carla M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.10.2021; BioMed Central; BMC
• Subjects: Adaptation; Adaptation, Physiological; Aerobics; Antineoplastic Agents - administration & dosage; Blood flow; Breast cancer; Breast Neoplasms - blood supply; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Caloric Restriction; Calorie restriction; Calories; Cancer; Cancer therapies; Carbohydrates; Care and treatment; Chemotherapy; Clinical Trials, Phase II as Topic; Combined Modality Therapy - methods; Computed tomography; Consent; Diet; Diet therapy; Diet, Ketogenic; Dietary Carbohydrates - administration & dosage; Dietary Fats - administration & dosage; Dietary restrictions; Dietitians; Diffusion coefficient; Energy metabolism; Ethics; Exercise; Exercise therapy; Female; Glucose; Glycolysis; Health aspects; High fat diet; Humans; Hypocaloric diet; Hypoxia; Infusions, Intravenous; Intervention; Intravenous administration; Ketogenesis; Ketogenic; Ketogenic diet; Low carbohydrate diet; Magnetic Resonance Imaging; Meals; Metastases; Metastasis; Metastatic; Methods; Nutrient deficiency; Nutrition research; Outcome Assessment, Health Care; Patients; Physical fitness; Quality of Life; Randomized Controlled Trials as Topic; Reducing diets; Skeletal muscle; Study Protocol; Survival; Testing; Toxicity; Tumor Burden; Tumor Hypoxia; Tumors; Canada; Chemotherapy; Exercise; Nutrition; Calorie restriction; Breast cancer; Metastatic; Ketogenic

An underlying cause of solid tumor resistance to chemotherapy treatment is diminished tumor blood supply, which leads to a hypoxic microenvironment, dependence on anaerobic energy metabolism, and impaired delivery of intravenous treatments. Preclinical data suggest that dietary strategies of caloric...