ReviewCaloric restriction - A promising anti-cancer approach: From molecular mechanisms to clinical trials

•Caloric restriction (CR) reduces the risk factors for various diseases, including cancer.•The downregulation of mTORC1 pathway is one of the most advantageous effects of CR.•PRAPα, AMPK, and Sirt1 depress glycolysis and promote ketogenesis in response to CR.•CR and CRMs are able to sensitize different tumors to chemo- or radiotherapy.•The most promising anti-tumor CRMs with approved efficacy are the mTOR inhibitors.

Cancer is the second leading cause of death worldwide and the morbidity is growing in developed countries. According to WHO, > 14 million people per year are diagnosed with cancer and about 8 million die. Anti-cancer strategy includes chemo-, immune- and radiotherapy or their combination. Unfortunately, these widely used strategies often have insufficient efficacy and significant toxic effects on healthy cells. Consequently, the improvement of treatment approaches is an important goal. One of promising schemes to enhance the effect of therapy is the restriction of calorie intake or some nutrients. The combination of caloric restriction or its chemical mimetics along with anti-cancer drugs may suppress growth of tumor cells and enhance death of cancer cells. That will allow the dose of therapeutic drugs to be decreased and their toxic effects to be reduced. Here the possibility of using this combinatory therapy as well as the molecular mechanisms underlying this approach will be discussed.

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