Skip to main content
Log in

Interaction between cytostatics and nutrients

  • Published:
Medical Oncology and Tumor Pharmacotherapy Aims and scope Submit manuscript

Abstract

Cancer patients have the highest prevalence of malnutrition of any group of hospitalized patients. The presence of the tumor alone may lead to reduced intake of different nutrients and treatment modalities such as surgery, chemotherapy and radiation therapy may further exacerbate nutritional disturbances. Dietary manipulation in experimental systems has shown improvement of tumor response to cancer therapy. Drug pharmacokinetics has been shown to be altered by changes in nutritional delivery. This article reviews the present knowledge, from experimental and clinical standpoints, of the potential role of different nutritional factors on the specific cancer treatment. It is obvious that alteration of at least some dietary factors affect the outcome of different forms of cancer treatment. Indeed, although interest in the clinical significance of optimal dietary intake and supplementation during cancer therapy so far remain marginal, accumulating data indicate that this area deserves further research attention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Goldin A: Dosing and sequencing for antineoplastic synergism in combination chemotherapy.Cancer 54, 1155 (1984).

    Article  PubMed  CAS  Google Scholar 

  2. Steel G G: The search for therapeutic gain in the combination of radiotherapy and chemotherapy.Radiother Oncol 11, 31 (1988).

    Article  PubMed  CAS  Google Scholar 

  3. Henriksson R, Grankvist K: Interactions of clinically used drugs with cancer treatment.Acta Oncol (in press).

  4. Toothaker R D, Welling P G: The effect of food on drug bioavailability.Am Rev Pharmacol Toxicol 20, 173 (1980).

    Article  CAS  Google Scholar 

  5. Chlebowski R T: Critical evaluation of the role of nutritional support with chemotherapy.Cancer 55, 268 (1985).

    Article  PubMed  CAS  Google Scholar 

  6. Welling P G: Influence of food and diet on gastrointestinal drug absorption. A Review.J pharmacol Biopharm 5, 293.

  7. Adair C G, Bridges J M, Desai Z R: Can food affect the bioavailability of chlorambucil in patients with haematological malignancies?Cancer Chemother Pharmacol 17, 99 (1986).

    Article  PubMed  CAS  Google Scholar 

  8. Adair C G, McElnay J C: The effect of dietary amino acids on the gastrointestinal absorption of melphalan and chlorambucil.Cancer Chemother Pharmacol 19, 343 (1987).

    Article  PubMed  CAS  Google Scholar 

  9. Bosanquet A G, Gilby E D: Pharmacokinetics of oral and intravenous melphalan during routine treatment of multiple myeloma.Eur J clin Oncol 18, 355 (1982).

    Article  CAS  Google Scholar 

  10. Bosanquet A G, Gilby E D: Comparison of fed and fasting states on the absorption of melphalan in multiple myeloma.Cancer Chemother Pharmacol 12, 183 (1984).

    Article  PubMed  CAS  Google Scholar 

  11. Burton N K, Barnett M J, Aherne G W, Evans J D I, Lister T A: Short communication. The effect of food on the oral administration of 6-mercaptopurine.Cancer Chemother Pharmacol 18, 90 (1986).

    Article  PubMed  CAS  Google Scholar 

  12. Harvey L P, Mehta B M, Bonau R A, Daly J M: Alteration of rnethotrexate pharmacokinetics and host toxicosis in rats by dietary manipulation.Surgical Pharm 35, 397 (1984).

    CAS  Google Scholar 

  13. McAnena O J, Ridge J A, Daly J M: Alteration of methotrexate metabolism in rats by administration of an elemental liquid diet.Cancer 59, 1091 (1987).

    Article  PubMed  CAS  Google Scholar 

  14. Gunnarsson P-O, Davidsson T, Andersson S-B, Backman C, Johansson S-Å: Impairment of estramus- tine phosphate absorption by concurrent milk and food intake.Eur J clin Pharmacol (in press).

  15. Chatterji D C, Yeager R L, Gallelli J T: Kinetics of chlorambucil hydrolysis using high pressure liquid chromatography.J Pharm Sci 71, 50 (1982).

    Article  PubMed  CAS  Google Scholar 

  16. Hocman G: Prevention of cancer: Restriction of nutritional energy intake (joules).Comp Biochem Physiol 91A (2), 209 (1988).

    Article  Google Scholar 

  17. Prasad K N, Sinha P K, Ramanujam M,et al.: Sodium ascorbate potentiates the growth inhibitory effect of certain agents on neuroblastoma cells in culture.Proc natn Acad Sci USA 76, 829 (1979).

    Article  CAS  Google Scholar 

  18. Myers C: Anthracyclines.Cancer Chemother 8, 52 (1986).

    Google Scholar 

  19. Grankvist K, Henriksson R: Doxorubicin and epirubicin iron-induced generation of free radicalsin vitro. A comparative study.Biosc Rep 7, 653 (1987).

    Article  CAS  Google Scholar 

  20. Herman E H, Ferrans V J, Myers C E, Van Vleet J F: Comparison of the effectiveness of 1,2-bis(3,5-dioxopiperazinyl-1-yl) propane (ICRF-187) andN-acetylcysteine in preventing chronic doxorubicin cardiotoxicity in beagles.Cancer Res 45, 276 (1985).

    PubMed  CAS  Google Scholar 

  21. Herman E H, Ferrans V J: Pretreatment with ICRF- 187 provides long-lasting protection against chronic daunorubicin cardiotoxicity in rabbits.Cancer Chemother Pharmacol 16, 102 (1986).

    Article  PubMed  CAS  Google Scholar 

  22. Henriksson R, Grankvist K: Protective effect of iron chelators on epirubicin-induced fibroblast toxicity.Cancer Lett 43, 179 (1988).

    Article  PubMed  CAS  Google Scholar 

  23. Satyamoorthy K, Chitnis M P, Pradham S G: Potentiation of hydroxyurea cytotoxicity by iron chelating agent in murine tumor models in vitro.Cancer Drug Delivery 3, 173 (1986).

    PubMed  CAS  Google Scholar 

  24. Sinha B K: Free radicals in anticancer drug pharmacology.Chem Biol Interact 69, 293 (1989).

    Article  PubMed  CAS  Google Scholar 

  25. Barnes D, Sato G: Methods for growth of cultured cells in serumfree medium.Analyt Biochem 102, 255 (1980).

    Article  PubMed  CAS  Google Scholar 

  26. Lederman, H M, Cohen A, Lee J W W, Fredman M H, Gelfand E W: Deferoxamine: A reversible S-phase inhibitor of human lymphocyte proliferation.Blood 64, 748 (1984).

    PubMed  CAS  Google Scholar 

  27. May W S, Jacobs S, Cuatrecasas P: Association of phorbol ester-induced hyperphosphorylation and reversible regulation of transfersive membrane receptors in HL60-cells.Proc natn Acad Sci USA 81, 2016 (1984).

    Article  CAS  Google Scholar 

  28. Forsbeck K: Control of tumor cell growthin vitro: Influence of the pharbol diester TPA and cellular iron metabolism. Acta Universitatis Upsaliensis. Comprehensive summaries of Uppsala dissertations from the Medical Faculty, vol 129.

  29. Speyer J Let al.: Protective effect of the bispiperazi- nedione ICRF-187 against doxorubicin-induced cardiac toxicity in women with advanced breast cancer.The New Engl J Med 319 (12), 745 (1988).

    Article  CAS  Google Scholar 

  30. Lyman S, Ujjani B, Renner K, Antholine W, Petering D H, Whetstone J W, Knight J M: Properties of the initial reaction of bleomycin and severed of its metal complexes with Ehrlich cells.Cancer Res 46, 4472 (1986).

    PubMed  CAS  Google Scholar 

  31. Baker G W, Duncan J R: Possible site of zinc control of hepatoma cell division.J natn Cancer Inst 70, 333 (1983).

    CAS  Google Scholar 

  32. Galatulas I, Bossa R: Effect of zinc supplementation on the antitumoural activity and toxicity of adria-mycin in mice.IRCS Med Sci 14, 942 (1986).

    CAS  Google Scholar 

  33. Dimitrov N V, Hay M B, Siew S, Hudler D A, Charamella L J, Ullrey D E: Abrogation of adriamycin-induced cardiotoxicity by selenium in rabbits.Am J Pathol 126, 376 (1987).

    PubMed  CAS  Google Scholar 

  34. Zidenberg-Cherr S, Keen C L: Influence of dietary manganese and vitamin E on adriamycin toxicity in mice.Toxicol Lett 30, 79 (1986).

    Article  PubMed  CAS  Google Scholar 

  35. Garattini S, D’Incalci M: Combinations of anticancer agents with other drugs.Prog Cancer Res Ther 31, 296 (1984).

    Google Scholar 

  36. Cohen M H, Carbone P P: Enhancement of the antitumor effect of l,3-bis(2-chloroethyl)-l-nitrosourea and cyclophosphamide by vitamin A.J natn Cancer Inst 48, 921 (1972).

    CAS  Google Scholar 

  37. Weinzweig J, Mendecki J, Friedenthal E, Levenson S M, Seifter E: Lewis lung tumor therapy: Additive effects of Vitamin A and arginine supplements.Fedn Proc 45, 1078 (1986).

    Google Scholar 

  38. McCormick D L, Moon R C: Retinoid-tamoxifen interaction in mammary cancer chemoprevention.Carcinogenesis 7, 193 (1986).

    Article  PubMed  CAS  Google Scholar 

  39. Israel L, Hajji O, Grefft-Alami A, Desmoulins D, Succari M, Cals M J, Miocque M, Breau J L, Morere J F: Augmentation par la vitamine A des effets de la chimiotherapie dans les cancers du sein metastas es apres la menopause. Essai randomis e sur 100 malades.Ann Med Interne 136, 551 (1985).

    CAS  Google Scholar 

  40. Akman S A, Doroshow J H, Dietrich M F, Chlebow-ski R T, Block J S: Synergistic cytotoxicity between menadione and dicumarol vs. Murine Leukemia L1210.J Pharmacol Exp Ther 240, 486 (1987).

    PubMed  CAS  Google Scholar 

  41. Gold J:In vivo Synergy of vitamin K3 and metho-trexate in tumor-bearing animals.Cancer Treat Rep 70, 1433 (1986).

    PubMed  CAS  Google Scholar 

  42. Chlebowski R T, Dietrich M, Akman S, Block J B: Vitamin K3 inhibition of malignant murine cell growth and human tumor colony formation.Cancer Treat Rep 69, 527 (1985).

    PubMed  CAS  Google Scholar 

  43. Miasishcheva N V, Gerasimova G K: Vliianie metil-kobalamina na trasport metotreksata v norma nye i opukholevye tkani.Bull Eksp Biol Med 99, 736 (1985).

    CAS  Google Scholar 

  44. Fortmeyer H P, Timm C, Blum U, Wenisch H J C, Förster H: Vitamin B6 responsive growth of human tumors.Anticancer Res 8, 813 (1988).

    PubMed  CAS  Google Scholar 

  45. Okunieff P, Suit H D: Toxicity, radiation sensitivity modification, and combined drug effects of ascorbic acid with misonidazolein vivo on FSaII murine fibrosarcoma.JNCI 79, 377 (1987).

    PubMed  CAS  Google Scholar 

  46. Yang T N, Ren C F, Pan H Q, Wang J L, Zhang Z Y, Su C H: Effect of vitamin C on thermal sensitivity of Lewis tumor.Chung Hua Chung Liu Tsa Chih 9, 421 (1987).

    PubMed  CAS  Google Scholar 

  47. Chiou S H, Ohtsu N: Antiproliferative and DNA scission activities of L-ascorbic acid in the presence of copper chelates.Proc natn Sci Council Repub China 9, 275 (1985).

    CAS  Google Scholar 

  48. Taper H S, de Gerlache J, Lans M, Roberfroid M: Non-toxic potentiation of cancer chemotherapy by combined C and K3 vitamin pre-treatment.Int J Cancer 40, 575 (1987).

    Article  PubMed  CAS  Google Scholar 

  49. Cervantes A, Pinedo H M, Lankelma J, Schuurhuis G J: The role of oxygen derived free radicals in the cytotoxicity of doxorubicin in multidrug resistant and sensitive human ovarian cancer cells.Cancer Lett 41, 169 (1988).

    Article  PubMed  CAS  Google Scholar 

  50. Begin M E, Ells G, Horrobin D F: Polyunsaturated fatty acidoinduced cytotoxicity against tumor cells and its relationship to lipid peroxidation.J natn Cancer Inst 80, 188 (1988).

    Article  CAS  Google Scholar 

  51. Said H M, Hollander D: Inhibitory effect of bile salts on the enterohepatic circulation of methotrexate in the unanesthetized rat: inhibition of methotrexate intestinal absorption.Cancer Chemother Pharmacol 16, 121 (1986).

    Article  PubMed  CAS  Google Scholar 

  52. Henriksson R, Franzén L, Littbrand B: Prevention of irradiation induced bowel discomfort: A double blind placebo controlled study when treating pelvic cancer.Am J Medicine (in press).

  53. Pozner J, Papatestas A E, Fagerström R, Schwartz I, Saevitz J, Feinberg M, Aufses A H: Association of tumor differentiation with caffeine and coffee intake in women with breast cancer.Surgery 100, 482 (1986).

    PubMed  CAS  Google Scholar 

  54. Timson J: Caffeine.Muta Res 47, 1 (1977).

    CAS  Google Scholar 

  55. Cohen M H: Enhancement of the antitumor effect of l,3-bis(2-chloroethyl)-l-nitrosourea by various psychotropic drugs in combination with caffeine.J Pharmac exp Ther 194, 475 (1975).

    CAS  Google Scholar 

  56. Osieka R, Glatte P, Pannenbäcker R, Schmidt C G: Enhancement of semustine-induced cytotoxicity by chlorpromazine and caffeine in a human melanoma xenograft.Cancer Treat Rep 70, 1167 (1986).

    PubMed  CAS  Google Scholar 

  57. Allen T E, Aliano N A, Cowan R J, Grigg G W, Hart N K, Lamberton J A, Lane A: Amplification of the antitumor activity of phleomycins and bleomycins in rats and mice by caffeine.Cancer Res 45, 2516 (1985).

    PubMed  CAS  Google Scholar 

  58. Basu T, Bishun N P, Williams D: Accentuation of the cell-killing effects of chlorambucil by phenobarbital, caffeine and vitamin A in culture.Cytobios 9, 115 (1974).

    PubMed  CAS  Google Scholar 

  59. Fraval H N, Roberts J J: Effects of cis-platinum (II) diaminedichloride on survival and the rate of DNA synthesis in synchronously growing Chinese hamster V79-379A cells in the absence and presence of caffeine inhibited post-replication repair; evidence for an inducible repair mechanism.Chem Biol Interact 23, 99 (1978).

    Article  PubMed  CAS  Google Scholar 

  60. Orstavik J: Caffeine sensitive recovery of mitomycin C treated mouse P-388 cells.Acta Pathol Microbiol Scand 80, 900 (1972).

    CAS  Google Scholar 

  61. Murnane J P, Byfield J E, Ward J F, Calabro-Jones, P: Effects of methylated xanthines on mammalian cells treated with bifunctional alkylating agents.Nature 285, 326 (1980).

    Article  PubMed  CAS  Google Scholar 

  62. Walker I G, Reid B D: Caffeine potentiation of the lethal action of alkylating agents on L-cells.Mutat Res 12, 101 (1971).

    PubMed  CAS  Google Scholar 

  63. Cohen M H, Schoenfeld D, Wolter J: Randomized trial of chlorpromazine, caffeine, and methyl-CCNU in disseminated melanoma.Cancer Treat Rep 64, 151 (1980).

    PubMed  CAS  Google Scholar 

  64. Kyle R A, Seligman B R, Wallace H J Jr,et al.: Multiple myeloma resistant to melphalan (NSC-8806) treated with cyclophosphamide (NSC-26271), prednisone (NSC-10023), and chloroquine (NSC-187208).Cancer Chemother Rep 59, 557 (1975).

    PubMed  CAS  Google Scholar 

  65. Daley-Yates P T, McBrien D C H: A study of the protective effect of chloride salts on cisplatin nephrotoxicity.Biochem Pharmac 34, 2363 (1985).

    Article  CAS  Google Scholar 

  66. Takiyama W, Hirai T, iMiyoshi Y, Yoshihara T, Hattori T: Enhanced antitumor effects of bleomycin and moderate hyperthermia by additional use of ethanol.Jap J Surgery 14, 262.

  67. Tobias H, Auerbach R: Hepatotoxicity of a long-term methotrexate therapy for psoriasis.Arch Intern Med 132, 391 (1973).

    Article  PubMed  CAS  Google Scholar 

  68. Balducci L, Philips M, Wallace C, Hardy C: Cancer chemotherapy in the elderly.Am Family Phys 35, 133 (1987).

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Henriksson, R., Rogo, K.O. & Grankvist, K. Interaction between cytostatics and nutrients. Med. Oncol. & Tumor Pharmacother. 8, 79–86 (1991). https://doi.org/10.1007/BF02988858

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02988858

Key words

Navigation