Table 3.

Major advantages and disadvantages of dietary and pharmacologic interventions targeting tumor metabolism

Metabolic interventionPotential advantagesPotential disadvantages
Dietary (fasting, ketogenic diets, FMD)
  • – Pleiotropic effects on several metabolic pathways

  • – Low costs

  • – Already available

  • – Synergistic with standard treatments

  • – Poor acceptance by some patients

  • – Poor applicability to cachectic patients

  • – Poor standardization

  • – Absence of dose–response effect

Pharmacologic
  • – Highly selective to tumor-specific metabolic alterations

  • – Low impact on patient lifestyle

  • – Predictable pharmacokinetic and pharmacodynamic effects

  • – Dose–response effect

  • – Efficacy restricted to tumors addicted to a specific metabolic pathway

  • – High costs

  • – Long times for drug production, preclinical testing, clinical development

  • – Fast metabolic adaptation and tumor resistance