Review Article | DOI: https://doi.org/DOI:10.31579/2690-4861/650

Effect of Intermittent Fasting on Cancer

  • Zemmour Amel 1*
  • Tabouri Sarah 2
  • Zeroual Sarah 1
  • Larbaoui Blaha 1

¹Department of Medical Oncology, Center for the fight against cancer of Oran. “Emir Abd El Kader” Faculty of Medicine - Ahmed Ben Bella University - Algeria.

²Department of Medical Oncology, Center for the fight against cancer of Sidi Bel Abbes.” Taleb Morad” Faculty of Medicine – Djillali Liabes University - Algeria.

*Corresponding Author: Zemmour Amel, Department of Medical Oncology, center for the fight against cancer of Oran, Emir Abd El Kader, Faculty of Medicine –Ahmed Ben Bella 1 University-Algeria.

Citation: Zemmour Amel ˲Tabouri Sarah, Zeroual Sarah, Larbaoui Blaha, (2025), Effect of Intermittent Fasting on Cancer, International Journal of Clinical Case Reports and Reviews, 22(4); DOI:10.31579/2690-4861/650

Copyright: © 2025, Zemmour Amel. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 11 December 2024 | Accepted: 25 December 2024 | Published: 17 January 2025

Keywords: fasting; cancer; treatment; recurrence

Abstract

Diet is a modifiable factor that may affect cancer risk, treatment and recurrence, currently there is a high level of interest in fasting and cancer in the scientific community but no clear information about the purported health benefits, fasting and fasting mimicking diets leads to wide alterations in growth factors and in metabolite levels giving rise to an unfavorable environment for cell proliferation, there are multiple examples of fasting diets that might regenerate antitumor immunity and may even prevent some types of tumors which are most likely to be sensitive to these dietary interventions, thus, the biologically-relevant interplay between fasting or nutrient deprivation and current cancer treatments encourages the design of future trials to maximize efficacy and achieve the lowest toxicity of current cancer treatments. 

Introduction

Humans evolved in environments where food was scarce, enabling them to function at high energy levels [1]. However, modern sedentary lifestyles and overconsumption of high-calorie foods have compromised health, leading to issues like insulin resistance, obesity, cardiovascular diseases, depression, and even cancer [1,2]. Fasting, a practice dating back to Hippocrates [2,3], is a safe and well-tolerated method that reduces oxidative stress, enhances stress resistance, delays aging, and potentially combats cancer [4,5]. Intermittent fasting (IF) is a specific eating pattern involving alternating periods of fasting (16-48 hours) and eating (8-12 hours) [6,7]. Lifestyle factors, including diet, contribute to approximately 42% of cancers and 45% of cancer-related deaths [8]. Despite significant advancements in oncology, cancer remains a major global health concern, affecting 19.97 million people and causing 10 million deaths in 2022 [9]. Survival rates and prognoses for cancer patients remain unsatisfactory. Recently, the fasting concept has become popular among scientists and the general population. In particular, fasting reputedly slows down ageing, improves overall health [4-7]. Proposed mechanisms for this effect include an induction of autophagocytosis of cancer cells and/or the idea that fasting may also protect healthy cells in cancer patients against the stress induced by chemotherapy [8-9]. In this review, we aim to describe the various types of fasting, their relationships with cancer treatments, and their effects on cancer, treatment responses, and survival in cancer patients.

Types of fast: 
Based on traditional, cultural or religious backgrounds, there are many types of periodic fasting, many types of fasting experience no or small caloric intake (eg 500 kcal daily) with an unlimited amount of caloric-free beverages (coffee without sugar or milk, water, diet soft drinks.) (Table1) [8,10].

Types of fastDescription
Complete alternate day fastingInvolves alternating fasting days and feeding days
Modified fasting regimensSevere energy restriction for 2 non-consecutive days per week and ad libitum eating for the other 5 days.
Time restricted feedingAllows ad libitum energy intake within specific time frames, inducing regular, extended fasting intervals.
Religious fastingVariety of fasting regimens undertaken for religious or spiritual purposes.
Ramadan fastingA fast from sunrise to sunset during the holy month of Ramadan, with one large meal after sunset and one lighter mean before dawn. Thus, for about 12 hours of length.
Other religious fastsSome Christians routinely abstain from food and drink for extended periods of time, some seventh –day Adventists consume their last of two daily meals in the afternoon, resulting in an extended nighttime fasting interval.

Table 1: Type of fasting

Because Calorie Restriction (CR) can have both very positive and negative effects and is unlikely to be adopted by a significant portion of the populations since it unavoidably causes severe weight loss, intermittent and periodic fasting are emerging as novel interventions which could maintain many of the beneficial effects of CR while reducing the burden and many of the side effects [10]. Fasting, the complete elimination of nutrients from the diet, is the most extreme of the dietary restrictions [11,12]. Fasting regimens can be implemented in various formats (table2). Intermittent fasting (IF) involves short-term, frequent fasting periods, such as alternate-day fasting (ADF) or time-restricted eating (TRE) [11-14]. In contrast, prolonged and periodic fasting (PF) entails less frequent but longer periods of fasting, often lasting 2-5 days or involving fasting-mimicking diets (FMD) for 4-7 days [15-18]. 

 Type of FastingScheduleDescription

Intermittent Fasting

(IF)

ADF24 h fast/ 24 h eating periodWater only fasting every other day
5:22 days fast or very low-calorie consumption (500–700 kcal)/ 5 days eating periodAlternation of 2 days of very low-calorie consumption with a 5 days ad libitum re-feeding period
TRF12- to 18 h fast/ 6- to 12 h eating periodFood intake restricted to 6–12 h per day

Periodic Fasting

(PF)

Prolonged fasting2–5 days of water fast/ 7 days eating period (or longer)Water only fasting period followed by an ad libitum re-feeding period
Prolonged FMD4- to 7 days FMD/ 10- to 25days eating period30–50% of the normal caloric intake using a fasting mimicking diet for 4–7 days followed by an ad libitum re-feeding period

Table 2: Dietary approaches to promote health span [15]

While IF typically involves alternating fasting and feeding phases, PF can be implemented sporadically throughout the year [11]. Both IF and PF induce metabolic adaptations, including decreased blood glucose levels, reduced glycogen stores, lower leptin levels, and increased fatty acid mobilization with ketone body production [11,18]. Additionally, fasting periods, particularly those involving FMD, can positively impact cognitive function, leading to heightened awareness, attention, mental acuity, vigilance, and reduced depressive symptoms [19].

Circadian Biology Cycle
The master biological clock is in the suprachiasmatic nucleus of the hypothalamus and is entrained to light and dark stimuli, it plays a major role in integrating metabolism and energetics, similar clock oscillators have been found in peripheral tissues (liver, fat and skeletal muscle..) desynchronization of this biological brain and peripheral clock may increase the risk of cancer, a large literature indicates that shift work is associated with increased risks of obesity, diabetes, cardiovascular disease and cancer, similarly consuming the majority of the day’s energy earlier in the day causes a lower weight and improves health [10].

Gastrointestinal microbiota
The diversity of the Gut microbiota is regulated by fasting, it increases production of short chain fatty acids, which can regulate insulin response and decreases inflammation [3].

Intermittent fasting should be contraindicated if there is a history of an eating disorder (anorexia, bulimia, malnutrition.) or pregnancy [3, 20-22].

Intermittent fasting and cancer 
Fasting leads to wide alterations in systemic levels of hormones, growth factors (insulin, glucagon, GH, IGF-1) which reduces the ability of tumor cells to adapt and survive, it can modulate cancer initiation, progression, and recurrence [3, 23-25].

In fasting, low serum levels of glucose impose extra stress on tumor cells, while healthy one’s function normally, these different responses cause more DNA damage and apoptosis in tumor cells and protects healthy cells from treatment damages, it is called differential stress sensitization –DSS [26-27].

IF promotes also stem cell-based regeneration, interestingly, in fasting, cytotoxic agents elicited differential response in normal and tumor cells, a phenomenon known as differential stress resistance –DSR- In healthy cells (Figure1), fasting shuts down pathways promoting growth to re-invest in repair pathways, thus tumor cells lose ability to adapt to extreme environments including caloric deprivation [1, 28,29].

This metabolic stress causes insulin levels to drop and glucagon levels to rise, increasing the breakdown of glycogen into glucose and triglycerides into free fatty acids, lipolysis is maintained by glucocorticoids and adrenalin as a result, fasting benefits the brain, muscle, liver, and adipose tissue, IF boosts fatty acid oxidation and induces a transition from aerobic glycolysis to mitochondrial oxidative phosphorylation in tumor cells [30]. The brain progressively adjusts using the ketone bodies in addition to glucose to satisfy its energy requirements, while other tissues use fatty acids to function. “Warburg effect” in fasting, the normal cells can replace glucose deprivation by ketone bodies and fatty acids, in contrast tumor cells depend on glucose, so it stimulates the aerobic glycolysis and produces lactic acid it’s “Warburg effect, sometimes an “anti-Warburg” effect result in oxidative stress and induced apoptosis of tumor cells [20,31,32].

Figure 1: Differential stress resistance mechanisms [30]

The possible mechanisms associated with the differential stress resistance theory. AKT: protein kinase B; IGF-1: insulin-like growth factor 1; IGFBP: insulin-like growth factor binding protein; mTOR: mechanistic target of rapamycin; RAS: rat sarcoma virus.

The related progression on IF combined with tumor therapy was listed in the Table 3.

Fasting has also several effects [3,15,21,31-34]:

  • FGF-21 increases and IGFBP1 binds IGF-1 thus causes IGF-1 deficiency, it can protect against cancer progression 
  • Vitamin B9 promotes DNA replication in cancer cells
  • Vitamin B12 and folic acid could also promote tumor progression 
  • Vitamin D increases calcium absorption
  • Autophagy eliminates intracellular signals and thus suggests cancer prevention role 
  • Decreases the production of free radicals 
  • Increases resistance to stress
  • Improves anti-stress ability
  • Reduces the level of reactive oxygen species (ROS and the expression of hypoxia inducible factor-1α
  • Current evidence suggests that intermittent

However, in practice, many physicians may consider fasting harmful for some kind of cancer patients weakened by a prior chemotherapy (aging with decreased appetite, nausea, taste changes.) [4].

Figure 2: The action of IF in tumor cell growth [7]

The molecular mechanism by which intermittent fasting (IF) affects tumor cell growth. Mechanistically, IF inhib is the IGF-1/AKT and mTORC1 pathways in tumor cells, while the AMPK, SIRT1, and SIRT3 pathways are activated. In addition, AMPK and SIRTs depend on each other in IF-associated metabolic adaptation. However, AMPK can induce activation of SIRT1 through NAMPT, while SIRT1 can activate AMPK through LKB1 regulation. FOXO3a (a downstream molecule of SIRT1 and SIRT3) and AMPK can each enhance the other’s transcriptional activities. Furthermore, SIRT3 inhibits tumor growth by activating FOXO3a and the expression of superoxide dismutase (SOD), thereby reducing the level of reactive oxygen species and negatively regulating the expression of HIF-1α. SIRT3 activates SOD2 via up regulation of FOXO3a. Furthermore, IF can selectively inhibit tumor growth by upregulating LEPR and its downstream signaling path way protein, PRDM1.

YearDisease(s)Dietary regimenOutcome
2020[35]Colorectal cancer and other KRAS-mutant tumorsStandard feeding or on the last day of the first IF cycle, vitamin C (4 g/kg in saline) began via intraperitoneal injection twice a day, with at least 6–8 between the 2 daily administrationsThe combination of IF and vitamin C represented a promising low toxicity intervention
2019[36]Orthotopic pancreatic tumorsFed or fasted for 24 h and then exposed to total abdominal radiation at a dose of 11.5 GyIF improved the survival of mice with orthotopic pancreatic tumors subjected to lethal abdominal radiation
2017[37]Colon cancer24 h fasting on alternate days for 2 weeksIF inhibited colon cancer growth and decreased the production of extracellular adenosine by cancer cells by suppressing CD73 expression
2016[38]Fibrosarcoma48 h fasting (water only) once vs. ad libitum feeding; animals were injected with mitoxantrone or oxaliplatin at the end of fastingIF improved the efficacy of chemotherapy in an immune system-dependent and autophagy-dependent fashion
2016[39]Breast cancer; melanoma48–60 h fasting (water only) or a 96 h FMD once a week for 2–4 weeks vs. ad libitum feeding; animals were injected with chemotherapy at the end of each fasting and/or FMD cycleIF slowed tumor progression when combined with doxorubicin or cyclophosphamide, expanded lymphoid progenitors and boosted anticancer immunity
2015[40]Colon cancer48 h fasting (water only) once a week for 2 weeks, 24 h prior to and 24 h after oxaliplatin injection vs. ad libitum feedingIF improved the anticancer effects of oxaliplatin, exerted anti-Warburg effects and promoted oxidative stress and apoptosis in cancer cells
2015[41]Lung cancer; colorectal cancer48 h fasting (water only) once a week for 3 weeks with daily treatment with crizotinib or regorafenib vs. ad libitum feedingIF improved the clinical activities of crizotinib and regorafenib
2012[42]

Mesothelioma; 

lung cancer

48 h fasting (water only) given once a week for 3 weeks, 32 h prior to and 16 h after cisplatin injection vs. ad libitum feedingIF sensitized human mesothelioma and lung cancer xenografts to cisplatin

Table 3: Overview of intermittent fasting (IF) combined with tumor therapy

Intermittent fasting in clinical trials
Most clinical trials of fasting in cancer patients performed to date are retrospective trials, observational studies evaluated in supportive care outcomes or phase I, II clinical trials, currently several well-powered studies are underway to address outstanding questions however, more extensive data are needed before intermittent fasting can be a routine clinical use [3], the DIRECT study evaluated the fasting mimicking diet (FMD) + neoadjuvant chemotherapy in women with HER 2 negative breast cancer, patients in the FMD group had a better pathological response and a decreased chemotherapy induced DNA damage to normal cells [30,43].

Another study on patients with breast cancer identified a potential beneficial of IF on chemotherapy induced toxicity [44].

Fasting and Cancer Prevention 
Data on the effect of IF suggest has a beneficial effect in preventing 60% of cancers in animal studies, a Swedish study found a 29% reduction in cancer incidence and 23% lower cancer mortality in a population who underwent a bariatric surgery, the look AHEAD trial of 4859 overweight patients who were randomized to an intensive group of CR (1200-1800 kcal daily) and an observational group, after 11 years patients in the intensive lifestyle group had a 16% lower incidence of obesity-related cancers (including esophagus, colon, rectum, kidney, pancreas, stomach, liver, gallbladder, thyroid, uterine, ovarian…) which the authors proposed was secondary to weight loss, though, there are no known, reproductible diets, to cure or prevent cancer recurrence, future well designed randomized clinical trials should examine the effect of IF over longer periods, different cancers and populations [8,29,45,46].

Fasting during specific treatments of cancer
IF has the potential to lower the ratio of fat to lean body mass, which may benefit patients at risk of weight–related side effects of some cancer treatments, many studies report improvements in quality of life, fatigue and GI toxicities [34], the fasting glucose, insulin and HbA1c of adults with obesity decreases significantly after short alternate- date regimens in some studies [10,47]. Glutamine is another metabolic substrate that has a high conversion rate in tumor cells, the catabolism of glutamine can protect tumor cells from chemical toxicity, fasting can increase chemosensitivity of cancer cells by affecting glutaminase and glutamine transporter levels [32].

Chemotherapy and radiotherapy
Fasting increases autophagy which is a catabolic process providing primary materials such as amino acids, fatty acids, nucleosides/nucleotides, sugars often induced by chemotherapeutic agents [48], many trial evaluates the combination of fasting with chemotherapy represents a potentially promising strategy to increase efficacy, reduce resistance and prevent side effects [25].

Normal cells are protected from chemotherapeutic agents by changes in circulating hormones and metabolites, during nutrient deprivation, they re-invest energy in maintenance and repair that contribute to resistance to chemotherapy while tumor cells are unable to slow-down growth due to mutations in tumor suppressor genes and mitogenic pathways, this different reaction makes tumor cells more susceptible to chemotherapy and other treatments since they violate the anti- proliferation signals required by fasting environment [31].Two days of fasting before chemotherapy treatment is safe and protect against the side effects of chemotherapy, this type of fasting is shown to delay the progression of several tumors especially in mice [27,49,].In addition, IF has been shown to increase tumor sensitivity to radiation therapy (RT) and prolong the survival of fasting experimental animals [Icard]. Specifically, mice with pancreatic tumors subjected to lethal abdominal radiation exhibited improved survival rates when subjected to IF compared to those with ad libitum food access. Additionally, IF did not impair RT-induced tumor cell killing and even enhanced γ-H2AX staining post-RT, suggesting a potential radio sensitizing effect [50]. Encouragingly, preclinical and preliminary clinical data support the notion that IF could serve as a complementary therapy to improve RT outcomes, both in terms of tumor control and reduced normal tissue toxicity [51,52]. While these basic studies have yielded promising results, further preclinical research is necessary to establish clinical relevance, as human data, including clinical outcome studies, safety data, and randomized controlled trials, remain limited [53]. Future investigations should prioritize safety and explore the potential of IF to enhance the efficacy of lower doses of chemotherapy and radiation therapy.

Hormones and fasting
Many studies demonstrate the link between nutrients and particularly protein intake, growth hormones, DNA damage and cancer, two major hormonal pathways appear to affect cancer incidence the IGF-1 and the insulin signaling [15].

Many dietary patterns, including the Western diet, are associated with reduced lifespan and health span and appear to affect cancer incidence by two major hormonal axes/pathways: the growth hormone-IGF1; the insulin signaling [54-56]. Breast cancer, particularly hormone receptor-positive (HR+) breast cancer, represents a significant health challenge. While endocrine therapies like Tamoxifen and Fulvestrant are effective, primary and acquired resistance often limits their long-term efficacy [57, 58].

A periodic fasting or a fasting-mimicking diet can enhance the effectiveness of endocrine therapies in mouse models of HR+ breast cancer. By lowering circulating levels of IGF-1, insulin, and leptin, and inhibiting the AKT-mTOR signaling pathway, these dietary interventions can potentiate the effects of tamoxifen and Fulvestrant. Moreover, combining a fasting-mimicking diet with a cyclin-dependent kinase 4/6 inhibitor like Palbociclib can lead to sustained tumor regression and overcome acquired drug resistance. (57,59) Importantly, fasting and fasting-mimicking diets can also mitigate the side effects of endocrine therapy, such as endometrial hyperplasia caused by tamoxifen. In human clinical trials, fasting-mimicking diets have been shown to induce similar metabolic changes as observed in mice, including reductions in insulin, leptin, and IGF-1 levels. (59,60) These findings suggest that fasting-mimicking diets hold promise as a potential adjuvant therapy for HR+ breast cancer. Further clinical studies are warranted to explore the optimal timing and duration of these dietary interventions and their impact on patient outcomes.

In a study by Lende et al., post-surgical breast cancer patients who fasted prior to surgery demonstrated significantly improved relapse-free and breast cancer-specific survival compared to those who received a carbohydrate-based nutritional supplement. This positive effect was particularly pronounced in patients with estrogen receptor-positive (ER+) breast cancer. Fasting appeared to favorably influence the hormonal environment, potentially enhancing the efficacy of subsequent treatments. While no significant difference was observed in estrogen receptor-negative patients, the study highlights the potential benefits of fasting for a specific subset of breast cancer patients [61].

Fasting and targeted therapy
Intermittent fasting (IF) has been shown to modulate various cellular pathways implicated in cancer progression. By decreasing insulin-like growth factor-1 (IGF-1) levels, IF can activate AMP-activated protein kinase (AMPK) and inhibit the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway [3,26,31,32]. Additionally, IF can enhance the efficacy of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, particularly Palbociclib, by reducing pharmacokinetic variability [26]. Furthermore, IF-induced inhibition of mechanistic target of rapamycin (mTOR) and activation of AMPK can stimulate autophagy, a cellular process that removes damaged organelles and misfolded proteins (Kalam, Psara). By reducing IGF-1 levels, IF can also inhibit the RAS/mitogen-activated protein kinase (MAPK) signaling pathway, leading to decreased activity of transcription factors involved in cell proliferation and growth [26, 32]. Overall, these findings suggest that IF can improve the efficacy of targeted therapies, such as tyrosine kinase inhibitors (TKIs), by inhibiting key signaling pathways involved in cancer cell growth and survival [31,32].

Immunotherapy and fasting
When butyrate metabolism is disrupted in colon cancer, it accumulates, inhibits cell development and causes cell death suggesting that microbiota may play a role in immunotherapy as well [10]. There is a growing appreciation for how the metabolic pathways activated in fasting interact with immune responses to control tumor growth [3] Anti-PD1 treatment is effective in melanoma with high levels of A. muciniphila low levels of circulating IGF-1 sensitize tumor cells to anti PD L1 [26,31]. fasting was also associated with fewer instances of immunotoxicity and adverse events. No study has reported the effects of ketogenic diet on immunotherapy outcomes; thus, it is not clear whether the glucose limitation will affect anti-tumor immunity [62].

Figure 3: the impact of intermittent fasting in cancer prevention and treatment [3]

Conclusion

While intermittent fasting holds significant potential as a tool to combat cancer, its current role in clinical practice remains limited. While preliminary evidence suggests potential benefits in specific contexts, such as reducing side effects of certain treatments, more robust and conclusive data is needed. It's crucial to acknowledge the potential risks, particularly for patients at risk of malnutrition or eating disorders. Unintentional weight loss can severely impact clinical outcomes, making fasting inadvisable in such cases. As such, a personalized approach is essential. Patients with cancer should consult with a registered dietitian specializing in oncology to determine the most appropriate dietary strategy for their individual needs. Future research will undoubtedly shed lighter on the optimal implementation of fasting regimens in cancer care. Ongoing clinical trials are exploring the impact of intermittent fasting on cancer incidence, treatment response, and overall survival. By carefully considering the potential benefits and risks, we can harness the power of fasting to improve cancer outcomes.

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

img

Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

img

Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

img

Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

img

Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

img

Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

img

Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

img

Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

img

Luiz Sellmann

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

img

Zhao Jia

Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."

img

Thomas Urban

We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.

img

David Vinyes