From the Guidelines
Fasting for 24 hours before a docetaxel infusion is not recommended as it has no proven benefit and may potentially be harmful. The most recent and highest quality study, published in 2021 1, recommends against all forms of diets that are not based on clinical evidence, have no proven efficacy, and that potentially could be harmful. This includes fasting, which may lead to insufficient intake of energy, fat, and protein, as well as the general risk of micronutrient deficiency.
The study emphasizes that there are no clinical trials demonstrating a benefit of fasting during chemotherapy, and therefore, it is not recommended before, during, or after the application of anticancer agents like docetaxel. The reason for this recommendation is also due to the known risks of malnutrition and because patients might be tempted to prolong fasting episodes.
Some earlier studies, such as the one published in 2017 1, suggested that short-term fasting before, during, and after chemotherapy might possibly increase the effectiveness and tolerability of cytotoxic treatment. However, these findings were based on small observational series and randomized trials, and further research is needed to confirm these results.
Given the current evidence, the best approach for patients receiving docetaxel infusion is to follow their oncologist's instructions regarding food intake, which generally does not include fasting requirements. Maintaining adequate nutrition and hydration is important during chemotherapy treatment, and patients should discuss evidence-based approaches with their oncologist to optimize their treatment.
Key points to consider:
- Fasting for 24 hours before docetaxel infusion has no proven benefit
- Fasting may lead to insufficient intake of energy, fat, and protein, and increase the risk of micronutrient deficiency
- Maintaining adequate nutrition and hydration is important during chemotherapy treatment
- Patients should follow their oncologist's instructions regarding food intake, which generally does not include fasting requirements
- Evidence-based approaches to optimize docetaxel treatment focus on appropriate premedication, hydration, and management of side effects, rather than fasting.
From the Research
Fasting Before Docetaxel Infusion
- Fasting for 24 hours before a Docetaxel infusion may have beneficial effects, as suggested by studies on short-term fasting and chemotherapy tolerance 2, 3.
- A randomized pilot study found that short-term fasting (24 hours before and after commencing chemotherapy) was well tolerated and reduced hematological toxicity of TAC (docetaxel/doxorubicin/cyclophosphamide) in HER2-negative breast cancer patients 2.
- Another study reviewed the effects of fasting on the response of cancer to chemotherapy and found that fasting may improve the response of tumor cells to chemotherapy by repairing DNA damage in normal tissues, upregulating autophagy flux, and altering apoptosis 3.
Docetaxel Infusion and Fasting
- Docetaxel is a cytotoxic taxane effective in the treatment of patients with breast cancer, and its clinical profile is well established 4.
- However, the optimal regimen for the treatment of patients with metastatic breast cancer after failure of prior chemotherapy has not been identified, and the efficacy of docetaxel monotherapy may vary depending on the patient population and treatment setting 4, 5, 6.
- While there is evidence to suggest that fasting may be beneficial before a Docetaxel infusion, more human studies with adequate sample size and follow-ups are required to confirm these findings 2, 3.
Key Findings
- Short-term fasting may reduce hematological toxicity of TAC in HER2-negative breast cancer patients 2.
- Fasting may improve the response of tumor cells to chemotherapy by repairing DNA damage in normal tissues and altering apoptosis 3.
- Docetaxel is an active drug for the treatment of patients with advanced squamous cell carcinoma of the head and neck, and its efficacy and tolerability have been established in various clinical trials 4, 5, 6.