Fasting-mimicking Diet With Chemo-immunotherapy in Non-small Cell Lung Cancer (NSCLC)

Inclusion Criteria:

1. ≥ 18 years at the time of informed consent
2. Ability to provide written informed consent and HIPAA authorization
3. Eastern cooperative group (ECOG) performance status of 0 to 2
4. Histologically confirmed Non-Small Cell Lung Cancer (NSCLC) and have advanced disease.
5. BMI ≥ 19
6. Patients should be on maintenance therapy for advanced NSCLC as defined as treatment with single agent immunotherapy, single agent chemotherapy plus immunotherapy or single agent molecularly targeted therapy for a minimum of 2 months prior to study entry
7. If a patient is on a treatment that lowers their ANC, their ANC has to be ≥ 1500 on the first day of fasting

Exclusion Criteria:

1. Self-reported weight loss of \> 10% in the 6 weeks prior to study entry
2. History of diabetes mellitus or patients with a known recent elevated A1c \> 6
3. History of symptomatic hypoglycemia
4. Prior therapies with inhibitors of IGF-1 such as

   1. Linsitinib
   2. Picropodophyllin
5. Concurrent use of somatostatin
6. Concurrent use of immunosuppressive medications including sirolimus, tacrolimus, mycophenolate mofetil, azathioprine, prednisone, dexamethasone, or cyclosporine
7. Significant food allergies (screening checklist in Appendix 3) which would make the subject unable to consume the food provided
8. History or current evidence of any medical or psychiatric condition, therapy that may confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the participating subject as deemed by the treating investigator.
9. Pregnant or lactating females are not eligible.