High-Dose IV Vitamin C Doubles Survival in Advanced Pancreatic Cancer, suggests study
Researchers have found in a randomised trial that High-dose IV vitamin C combined with standard chemotherapy significantly extended survival in patients with advanced pancreatic cancer. Results showed that this combination nearly doubled overall survival (OS), delayed the impact of adverse events, and improved quality of life. Further, the addition of vitamin C did not increase adverse events.
Patients with metastatic pancreatic ductal adenocarcinoma (PDAC) have poor 5-year survival. Pharmacological ascorbate (P-AscH-, high dose, intravenous, vitamin C) has shown promise as an adjunct to chemotherapy. They hypothesised adding P-AscH- to gemcitabine and nab-paclitaxel would increase survival in patients with metastatic PDAC. Patients diagnosed with stage IV pancreatic cancer were andomized 1:1 to gemcitabine and nab-paclitaxel only (SOC, control) or to SOC with concomitant P-AscH−, 75 g three times weekly (ASC, investigational). The primary outcome was overall survival with secondary objectives of determining progression-free survival and adverse event incidence. Quality of life and patient-reported outcomes for common oncologic symptoms were captured as an exploratory objective. Thirty-six participants were randomized; of this 34 received their assigned study treatment. All analyses were based on data frozen on December 11, 2023.
Results: Intravenous P-AscH- increased serum ascorbate levels from micromolar to millimolar levels. P-AscH- added to the gemcitabine + nab-paclitaxel (ASC) increased overall survival to 16 months compared to 8.3 months with gemcitabine + nab-paclitaxel (SOC). Median progression-free survival was 6.2 (ASC) vs. 3.9 months (SOC). Adding P-AscH- did not negatively impact quality of life or increase the frequency or severity of adverse events. P-AscH− infusions of 75 g three times weekly in patients with metastatic pancreatic cancer prolong overall and progression-free survival without detriment to quality of life or added toxicity.
Reference:
Bodeker, K. L., Smith, B. J., Berg, D. J., Chandrasekharan, C., Sharif, S., Fei, N., Vollstedt, S., Brown, H., Chandler, M., Lorack, A., McMichael, S., Wulfekuhle, J., Wagner, B. A., Buettner, G. R., Allen, B. G., Caster, J. M., Dion, B., Kamgar, M., Buatti, J. M., & Cullen, J. J. (2024). A randomized trial of pharmacological ascorbate, gemcitabine, and nab-paclitaxel for metastatic pancreatic cancer. Redox Biology, 103375. https://doi.org/10.1016/j.redox.2024.103375
Keywords:
High-Dose, IV, Vitamin C, Doubles, Survival, Advanced, Pancreatic, Cancer, suggests, study , Pancreatic, neoplasms, Ascorbic acid, Controlled, clinical, trial, Gemcitabine, Nab-paclitaxel, Bodeker, K. L., Smith, B. J., Berg, D. J., Chandrasekharan, C., Sharif, S., Fei, N., Vollstedt, S., Brown, H., Chandler, M., Lorack, A., McMichael, S., Wulfekuhle, J., Wagner, B. A., Buettner, G. R., Allen, B. G., Caster, J. M., Dion, B., Kamgar, M., Buatti, J. M., & Cullen, J. J.
