30 Aug 2016 --- New findings have shown that by supplementing an epigenetic cancer drug called decitabine with vitamin C, it enhanced the drug's ability to impede cancer cell growth and trigger cellular self-destruction in cancer cell lines, prompting the start of a dedicated pilot study.
The pilot clinical trial involving adult patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) at Rigshospitalet in Copenhagen, Denmark, will combine a drug called azacitidine, the standard of care therapy, with vitamin C.
Many cancer patients are deficient in vitamin C; the proposed approach seeks to correct this deficiency rather than overload patients with the vitamin.
"If the pilot trial is successful, we plan to pursue a larger trial to explore this strategy's potential as a straightforward and cost-effective way to improve the existing therapy for AML and MDS," said Peter Jones, Ph.D., D.Sc., co-senior author of the PNAS study, chief scientific officer at Van Andel Research Institute (VARI) and co-leader of the Van Andel Research Institute-Stand Up To Cancer (VARI-SU2C) Epigenetics Dream Team.
However, the authors of the study urge patience and caution. Kirsten Grønbæk, M.D., DMSc., chief hematologist and professor at University of Copenhagen’s Rigshospitalet and member of the VARI-SU2C Epigenetics Dream Team, told NutritionInsight: “We will only know if the results of this study will impact actual cancer treatment after a large randomized clinical trial that will run from next year if the pilot data comes out positively. Generally 90 percent of aza patients will have responded after 6 months. Thus I would say we would know whether or not this impacts treatment of MDS/AML within the next 2-3 years.”
The proposed strategy reflects a continuing move toward combination therapies, particularly when it comes to epigenetic approaches, which target the mechanisms that control whether genes are switched "on" or "off."
"This type of combination therapy is promising but more work is needed to determine its safety and efficacy," Grønbæk said. "It is truly exciting to consider that there could be a simple and elegant approach to help patients fight MDS and AML. However, as a physician, I strongly urge patients to wait for the results of the clinical trial and to discuss all dietary and supplemental changes with their doctors."
There are hopes that this study could prompt research into how vitamin C could improve treatments for other types of cancer, too.
“We investigated cell lines from various cancers and observed similar effects,” explained Grønbæk, “However, hypomethylating drugs are only used in clinical trials in solid tumors. It would be relevant to also investigate the effects of vitamin C supplement in these trials. However, only controlled clinical trials can answer that question.”
For now, the clinical study will look at adult patients with MDS or AML. “We are currently running a pilot trial of 20 patients,” said Grønbæk, “If this comes out positively, we will run a large clinical trial with participating hospitals from US and Nordic countries.”
by Hannah Gardiner
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