Pharmacological possibilities of vitamin C in oncology

Czech version

Authors: Marek Lapka
Authors‘ workplace: Ústav farmakologie 3. lékařské fakulty UK, Praha
Published in: Vnitř Lék 2022; 68(2): 131-134
Category:

Overview

Ascorbic acid is a well-described molecule which acts as a cofactor in many reactions and mediates a variety of biological functions. Despite its simple structure, vitamin C has a wide range of interesting effects that bring enormous potential to the clinical practice. The article summarizes available data on efficacy and safety in oncology.

Keywords:

Vitamin C – Safety – oncology – pharmacology – effect

Sources

1. Buettner GR, Jurkiewicz BA. Catalytic metals, ascorbate and free radicals: combinations to avoid. Radiat Res.1996;145,532-541.

2. Li Y, Schellhorn HE. New developments and novel therapeutic perspectives for vitamin C. J Nutr. 2007;137:2171-84.

3. Jacob RA, Sotoudeh G. Vitamin C function and status in chronic disease. Nutr Clin Care. 2002;5:66-74.

4. Gershoff SN. Vitamin C (ascorbic acid): new roles, new requirements? Nutr Rev. 1993; 51:313-26.

5. Stephen R, Utecht T. Scurvy identified in the emergency department: a case report. J Emerg Med. 2001;21:235-7.

6. Wang AH, Still C. Old world meets modern: a case report of scurvy. Nutr Clin Pract. 2007;22:445-8.

7. Mayland CR, Bennett MI, Allan K. Vitamin C deficiency in cancer patients. Palliat Med 2005; 19: 17–20

8. Oak AS, Jaleel T, Fening K et al. 2016. A case of scurvy associated with nilotinib. J. Cut Pathol. 43;725-726.

9. Shenoy N, Bhagat T, Nieves E, et al. Upregulation of TET activity with ascorbic acid induces epigenetic modulation of lymphoma cells. Blood Cancer J.2017;7:e587.

10. Pullar JM, Carr AC, Bozonet SM, et al. High Vitamin C Status Is Associated with Elevated Mood in Male Tertiary Students. Antioxidants (Basel). 2018;7(7):91.

11. Du JJ, Cullen GR et al. Ascorbic acid: chemistry, biology and the treatment of cancer. Biochim. Biophys. Acta. 2012;1826:443-457.

12. Buettner GR and Schafer FQ. Ascorbate as an Antioxidant in Vitamin C. In: Asard H, May JM and Smirnoff N, Eds., Functions and Biochemistry in Animals and Plants, Bios Scientific Publishers. 2004.173-188.

13. Chen Q, Espey MG, Sun AY et al. Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Proceedings of the National Academy of Sciences of the USA. 2008;105:11105-11109.

14. Klimant E, Wright H, Rubin D. Intravenous vitamin C in the supportive care of cancer patients: a review and rational approach. Curr Oncol. 2018;25:39-148. 3.

15. Böttger F, Vallés‑Martí A, Cahn L et al. High‑dose intravenous vitamin C, a promising multi‑targeting agent in the treatment of cancer. J Exp Clin Cancer Res. 2021;40(1):343.

16. Yeom CH, Jung GC, Song KJ. Changes of terminal cancer patients’ health‑related quality of life after high dose vitamin C administration. J Korean Med Sci. 2007;22:7-11.

17. Vollbracht C, Schneider B, Leendert V, et al. Intravenous vitamin C administration improves quality of life in breast cancer patients during chemo-/radiotherapy and aftercare: results of a retrospective, multicentre, epidemiological cohort study in Germany. In Vivo. 2011;25:983-90.

18. Takahashi H, Mizuno H, Yanagisawa A. High‑dose intravenous vitamin C improves quality of life in cancer patients. Personalized Medicine Universe. 2012;1:49-53.

19. Ngo B, Van Riper JM, Cantley CL et al. Targeting cancer vulnerabilities with high‑dose vitamin C. Nature Reviews Cancer. 2019;19:271-282.

20. Wang F, He MM, Wang ZX et al. Phase I study of high‑dose ascorbic acid with mFOLFOX6 or FOLFIRI in patients with metastatic colorectal cancer or gastric cancer. BMC Cancer. 2019;19:460.

21. Welch JS, Klco JM, Gao F et al. Combination decitabine, arsenic trioxide, and ascorbic acid for the treatment of myelodysplastic syndrome and acute myeloid leukemia: a phase I study. AJH. 2011;86:796-800.

22. Aldoo I, Mark L, Vrona J et al. Adding ascorbic acid or arsenic trioxide produces limited benefit in patients with acute myeloid leukemia excluding acute promyelocytic leukemia. Ann Hematol. 2014;93:1839-1843.

23. Zhao H, Zhu H, Huang J et al. The synergy of vitamin C with decitabine activates TET2 in leukemic cells and significantly improves overall survival in elderly patients with acute myeloid leukemia. Leuk Res. 2018;66:1-7.

24. Das AB, Kakadia PM, Wojcik D et al. Clinical remission following ascorbate treatment in a case of acute myeloid leukemia with mutations in TET2 and WT1. Blood Cancer. 2019;9:82.

25. Gill HS, Yim R, Kumana CR et al. Oral arsenic trioxide, all‑trans retinoic acid, and ascorbic acid maintenance after first complete remission in acute promyelocytic leukemia: long‑term results and unique prognostic indicators. Cancer. 2020;126:3244-3254.

26. Khaw KT, Bingham S, Welch A et al. Relation between plasma ascorbic acid and mortality in men and women in EPIC‑Norfolk prospective study: a prospective population study. European Prospective Investigation into Cancer and Nutrition. Lancet. 2001;357:657-663.

27. Ma Y, Chapman J, Levine M et al. High‑dose parenteral ascorbate enhanced chemosensitivity of ovarian cancer and reduced toxicity of chemotherapy. Sci Transl Med. 2014;6:222ra18.

28. Padayatty SJ, Sun AY, Chen Q et al. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010;5:e11414.

29. Hoffer LJ, Levine M, Assouline S, et al. Phase i clinical trial of i.v. ascorbic acid in advanced malignancy. Ann Oncol. 2008;19:1969-1974.