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8 augustus 2022: lees ook dit artikel: https://kanker-actueel.nl/vitamine-c-hoog-gedoseerd-naast-chemo-folfox-bevacizumab-geeft-in-vergelijking-met-alleen-chemo-statistisch-significant-verschil-in-mediane-overall-overleving-bij-inoperabele-onbehandelde-uitgezaaide-darmkanker-met-ras-mutatie.html
10 mei 2022: Bron: 2020 Oct;25(10):1814-1821. Epub 2020 Jun 27.
Uit een kleinschalige maar wel gerandomiseerde studie blijkt dat orale toediening van cystine en theanine naast een chemokuur met FOLFOX6 (5-FU, leucovorin en oxaliplatin) een beschermend effect heeft voor het ontstaan van perifere neuropathie veroorzaakt door oxaliplatine.
Cystine en theanine is een supplement dat 700 mg cystine en 280 mg theanine bevat. Na orale suppletie worden cystine en theanine in aanwezigheid van glycine omgezet in respectievelijk cysteïne en glutaminezuur [zie ref. 9, 10]. Cysteïne en glutaminezuur worden uiteindelijk gesynthetiseerd tot glutathion, een sterke antioxidant. Van glutathion en zijn voorlopers, N-acetylcysteïne en glutamine, is aangetoond dat ze beschermende effecten hebben tegen neuropathie veroorzaakt door oxaliplatin. [11–14].
De onderzoekers volgden totaal 28 patiënten die FOLFOX6 kregen gelijk verdeeld in 14 patiënten voor elke groep (N = 14 om 14) middels een vragenlijst van 7 vragen. Om de mate van perifere neuropathie te beoordelen, hebben zij een vragenlijst met 7 items gemaakt op basis van de Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) Questionnaire [18] (Table (Table1).1).
De karakteristieken, zoals geslacht, leeftijd en stadium van ziekte van de deelnemende patiënten zijn weergegeven in Table2.2.
Uit het abstract de resultaten vertaald:
Bijwerkingen:
- Neuropathiescores volgens onze oorspronkelijke vragenlijst waren significant kleiner in de Cystine/Theanine-groep dan in de controlegroep bij de vierde (respectievelijk 1,17 en 3,08, p = 0,026), de vijfde (respectievelijk 1,09 en 3,36, p = 0,029) en zesde chemokuur (respectievelijk 1,27 en 4,18, p = 0.038) (Fig. 1)
- Verder werden ook significante verschillen waargenomen in CTCAE-neuropathiegraden bij de vierde (respectievelijk 0,55 en 0,92, p = 0,037) en de zesde chemokuur (respectievelijk 0,55 en 1,00, p = 0,017) (Fig. 2).
- Behalve neurotoxiciteit waren bijwerkingen (AE's) groter dan graad twee aanwezig bij tien patiënten in elke groep, en de incidenties van elke AE waren niet verschillend tussen de groepen ((Table3).3).
- Bijwerkingen van graad drie werden gemeld bij drie patiënten in de Cystine/Theanine-groep en bij vier patiënten in de controlegroep (p = 0,66), en er waren geen bijwerkingen hoger dan graad vier in elke groep.
- Er waren in dit onderzoek geen bijwerkingen die toe te schrijven waren aan cystine en theanine.
Int J Clin Oncol. 2020; 25(10): 1814–1821.
Published online 2020 Jun 27. doi: 10.1007/s10147-020-01728-4
PMCID: PMC7498479
PMID: 32594273
Protective effect of the oral administration of cystine and theanine on oxaliplatin-induced peripheral neuropathy: a pilot randomized trial
This article has been cited by other articles in PMC.
Associated Data
Abstract
Background
Oxaliplatin, one of the key cytotoxic drugs for colorectal cancer, frequently causes peripheral neuropathy which leads to dose modification and decreased patients’ quality of life. However, prophylactic or therapeutic measures have not yet been established. Orally administered amino acids, cystine and theanine, promoted the synthesis of glutathione which was one of the potential candidates for preventing the neuropathy. The aim of this study was to determine whether daily oral administration of cystine and theanine attenuated oxaliplatin-induced peripheral neuropathy (OXLIPN).
Methods
Twenty-eight colorectal cancer patients who received infusional 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) therapy were randomly and evenly assigned to the cystine and theanine group and the control group. OXLIPN was assessed up to the sixth course using original 7-item questionnaire as well as Common Terminology Criteria for Adverse Events (CTCAE) grading scale.
Results
Neuropathy scores according to our original questionnaire were significantly smaller in the cystine and theanine group at the fourth (p = 0.026), fifth (p = 0.029), and sixth course (p = 0.038). Furthermore, significant differences were also observed in CTCAE neuropathy grades at the fourth (p = 0.037) and the sixth course (p = 0.017). There was one patient in each group who required dose reduction due to OXLIPN. Except for neurotoxicity, no significant differences were noted in the incidence of adverse events, and the total amount of administered oxaliplatin.
Conclusion
The results demonstrated the daily oral administration of cystine and theanine attenuated OXLIPN.
Electronic supplementary material
The online version of this article (10.1007/s10147-020-01728-4) contains supplementary material, which is available to authorized users.
Acknowledgements
The authors wish to thank Makiko Kashima, B.Sc., Atsushi Kudoh, Ph.D., Kazuki Takahashi, B.Sc., and Tsukushi Abe, B.Sc. (Department of Pharmacy, Sendai City Medical Center, Sendai City, Miyagi Prefecture, Japan) for their support in the AE consultations that were conducted by telephone.
Compliance with ethical standards
Conflict of interest
No author has any conflict of interest.
Footnotes
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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