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Can Vitamin C (Ascorbate) Improve Treatment Response in Brain Cancer Patients?

Mar 9, 2020

Highlights

A clinical study has demonstrated that use (infusion) of high dose ascorbate (vitamin C) has the potential of improving the overall survival of brain cancer (GBM) patients who have a poor prognosis. The Vitamin C given along with the standard of care radiation and Temozolomide treatments also has the potential to lower the side-effects, thus improving the quality of life of the patient.



Brain Cancer – Glioblastoma

Glioblastoma (GBM) is the most common primary brain cancer. The standard of care treatment for GBM includes a combination of surgical resection of the brain tumor followed by concurrent radiation (RT) and temozolomide (TMZ) treatment. In many cases, this is followed by additional cycles of adjuvant TMZ post radiation. Despite the development of novel cancer drugs and all the advances in treatment, the prognosis for GBM patients continues to be quite dismal, with an overall survival of 14-16 months and a 5-year survival of less than 10%. (Stupp R et al, The Lancet Oncol., 2009; Gilbert MR et al, New Engl. J Med., 2014)

Use of Vitamin C in Brain Cancer

Vitamin C /Ascorbic Acid Use in Brain Cancer

Preclinical studies and even clinical trials in other cancer indications had shown a beneficial effect of using high dose Vitamin C infusions to be safe and to improve efficacy and lower toxicity when used along with radiation and chemotherapy treatments.

A first in human clinical study was done on 11 newly diagnosed GBM patients by the Department of Radiation Oncology at the University of Iowa hospital, to assess the safety and impact of pharmacological ascorbate infusion, given along with the standard of care treatment for GBM. (Allen BG et al, Clin Cancer Res., 2019) High dose ascorbate was infused 3 times a week during the RT/TMZ treatment cycles and twice weekly during the adjuvant TMZ cycles. Of the 11 subjects in this study, 8 of them had poor prognosis based on the unmethylated status of their MGMT enzyme, a known factor for lower response to TMZ. Historical data indicates that GBM patients without MGMT promoter methylation have an overall survival of only 12 months while the subjects in this study without MGMT promoter methylation had an overall survival of 23 months with 3 subjects still alive. The only negative effects experienced by the subjects were dry mouth and chills associated with the ascorbate infusion, while the other more severe side-effects of fatigue, nausea and even hematological adverse events associated with TMZ and RT were decreased.

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Conclusion


This study suggests that infusing high dose Vitamin C or ascorbate in brain cancer (GBM) patients being treated with RT/TMZ therapy cycles has the potential to improve overall survival, especially in the subjects with unmethylated MGMT marker that are known to have a poor prognosis. The study indicates that pharmacological ascorbate infusion can not only improve therapeutic tolerability of RT and TMZ, but has the potential for increasing a patients’ quality of life and decreasing toxicity of radiation and chemotherapy treatment regimen. High dose vitamin C (ascorbate) infusion has also shown promise in reducing toxicity of chemotherapies such as gemcitabine, carboplatin and paclitaxel in pancreatic and ovarian cancers. (Welsh JL et al, Cancer Chemother Pharmacol., 2013; Ma Y et al, Sci. Transl. Med., 2014) The researchers suggest that the results of their study on this very small cohort of patients are still sufficiently promising to merit a further clinical investigation.


Cancer patients often have to deal with different chemotherapy side effects which affect their quality of life and look out for alternative therapies for cancer. Taking the right nutrition and supplements based on scientific considerations (avoiding guesswork and random selection) is the best natural remedy for cancer and treatment related side-effects.


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