AUTOPHAGY IN COLORECTAL CANCER INITIATES THE DUAL MECHANISMS LINKING INTERMITTENT FASTING TO PREVENTION AND THERAPY RESISTANCE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Colorectal cancer ranks as the second leading cause of cancer-related mortality globally, with incidence more than doubling between 1990 and 2021. Autophagy is a conserved cellular process with paradoxical, stage-specific roles in CRC: it suppresses early tumorigenesis by maintaining genomic and metabolic homeostasis but supports established tumors under metabolic stress. Intermittent fasting (IF) activates autophagy via AMPK/mTOR/SIRT1 pathways, yet KRAS-driven CRC may exploit this same pathway for survival. No systematic synthesis has simultaneously mapped autophagy's role in CRC prevention versus therapy resistance across dietary, genetic, and pharmacologic interventions