Zie ook literatuurlijst niet-toxische stoffen en voeding specifiek bij darmkanker van arts-bioloog drs. Engelbert Valstar.

Als donateur kunt u korting verkrijgen op voedingsupplementen zoals genoemde cystine en theanine in onderstaand artikel bij verschillende bedrijven / organisaties, zie hier. 

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 oxaliplatineen 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. ]. 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. [].
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  [] (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.
Het volledige studierapport is gratis in te zien. Klik op de titel van het abstract:

Associated Data

Supplementary Materials

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.

Funding

This work was supported by Ajinomoto Co., Inc.

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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References

1. GLOBOCAN database 2018. https://gco.iarc.fr/today/home. Accessed 20 Jan 2020
2. Maindrault-Goebel F, de Gramont A, Louvet C, et al. Evaluation of oxaliplatin dose intensity in bimonthly leucovorin and 48-hour 5-fluorouracil continuous infusion regimens (FOLFOX) in pretreated metastatic colorectal cancer. Ann Oncol. 2000;11:1477–1483. doi: 10.1023/A:1026520812351. [PubMed] [CrossRef[]
3. Kidani Y, Noji M, Tashiro T. Antitumor activity of platinum (II) complexes of 1,2-diamino-cyclohexane isomers. GANN Jpn J Cancer Res. 1980;71:637–643. [PubMed[]
4. Pasetto LM, D'Andrea MR, Rossi E, et al. Oxaliplatin-related neurotoxicity: how and why? Crit Rev Oncol Hematol. 2006;59:159–168. doi: 10.1016/j.critrevonc.2006.01.001. [PubMed] [CrossRef[]
5. Pachman DR, Qin R, Seisler DK, et al. Clinical course of oxaliplatin-induced neuropathy: results from the randomized phase III trial N08CB (alliance) J Clin Oncol. 2015;33:3416–3422. doi: 10.1200/JCO.2014.58.8533. [PMC free article] [PubMed] [CrossRef[]
6. André T, Boni C, Mounedji-Boudiaf L, et al. Multicenter international study of oxaliplatin/5-fluorouracil/leucovorin in the adjuvant treatment of colon cancer (MOSAIC) investigators. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med. 2004;350:2343–2351. doi: 10.1056/NEJMoa032709. [PubMed] [CrossRef[]
7. Gebremedhn EG, Shortland PJ, Mahns DA. Variability of oxaliplatin-induced neuropathic pain symptoms in each cycle and its implications on the management of colorectal cancer patients: a retrospective study in South Western Sydney Local Health District Hospitals, Sydney. Australia J Oncol. 2019;2019:4828563. [PMC free article] [PubMed[]
8. Hershman DL, Lacchetti C, Sworkin RH, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: american society of clinical oncology clinical practice guideline summary. J Clin Oncol. 2014;32:1941–1967. doi: 10.1200/JCO.2013.54.0914. [PubMed] [CrossRef[]
9. Rimaniol AC, Mialocq P, Clayette P, et al. Role of glutamate transporters in the regulation of glutathione levels in human macrophages. Am J Physiol Cell Physiol. 2001;281:C1964–C1970. doi: 10.1152/ajpcell.2001.281.6.C1964. [PubMed] [CrossRef[]
10. Asatoor AM. Tea as a source of urinary ethylamine. Nature. 1966;210:1358–1360. doi: 10.1038/2101358b0. [PubMed] [CrossRef[]
11. Cascinu S, Catalano V, Cordella L, et al. Neuroprotective effect of reduced glutathione on oxaliplatin-based chemotherapy in advanced colorectal cancer: a randomized, double-blind, placebo-controlled trial. J Clin Oncol. 2002;20:3478–3483. doi: 10.1200/JCO.2002.07.061. [PubMed] [CrossRef[]
12. Milla P, Airoldi M, Weber G, et al. Administration of reduced glutathione in FOLFOX4 adjuvant treatment for colorectal cancer: effect on oxaliplatin pharmacokinetics, Pt-DNA adduct formation, and neurotoxicity. Anticancer Drugs. 2009;20:396–402. doi: 10.1097/CAD.0b013e32832a2dc1. [PubMed] [CrossRef[]
13. Lin PC, Lee MY, Wang WS, et al. N-acetylcysteine has neuroprotective effects against oxaliplatin-based adjuvant chemotherapy in colon cancer patients: preliminary data. Support Care Cancer. 2006;14:484–487. doi: 10.1007/s00520-006-0018-9. [PubMed] [CrossRef[]
14. Wang WS, Lin JK, Lin TC, et al. Oral glutamine is effective for preventing oxaliplatin-induced neuropathy in colorectal cancer patients. Oncologist. 2007;12:312–319. doi: 10.1634/theoncologist.12-3-312. [PubMed] [CrossRef[]
15. Tsuchiya T, Honda H, Oikawa M, et al. Oral administration of the amino acids cystine and theanine attenuates the adverse events of S-1 adjuvant chemotherapy in gastrointestinal cancer patients. Int J Clin Oncol. 2016;21:1085–1090. doi: 10.1007/s10147-016-0996-7. [PMC free article] [PubMed] [CrossRef[]
16. Common Terminology Criteria for Adverse Events version 4.0. https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm. Accessed 20 Jan 2020
17. ECOG performance status. https://www.npcrc.org/files/news/ECOG_performance_status.pdf. Accessed 20 Jan 2020
18. Calhoun EA, Welshman EE, Chang CH, et al. Psychometric evaluation of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire for patients receiving systemic chemotherapy. Int J Gynecol Cancer. 2003;13:741–748. [PubMed[]
19. Bogliun GML, Marzola M, Miceli MD, et al. Neurotoxicity of cisplatin +/- reduced glutathione in the first-line treatment of advanced ovarian cancer. Int J Gynecol Cancer. 1996;6:415–419. doi: 10.1046/j.1525-1438.1996.06050415.x. [CrossRef[]
20. Schmidinger M, Budinsky AC, Wenzel C, et al. Glutathione in the prevention of cisplatin induced toxicities. A prospectively randomized pilot trial in patients with head and neck cancer and non small cell lung cancer. Wien Klin Wochenschr. 2000;112:617–623. [PubMed[]
21. Leal AD, Qin R, Atherton PJ, et al. North Central Cancer Treatment Group/Alliance trial N08CA-the use of glutathione for prevention of paclitaxel/carboplatin-induced peripheral neuropathy: a phase 3 randomized, double-blind, placebo-controlled study. Cancer. 2014;120:1890–1897. doi: 10.1002/cncr.28654. [PMC free article] [PubMed] [CrossRef[]
22. Hong SY, Gil HW, Yang JO, et al. Pharmacokinetics of glutathione and its metabolites in normal subjects. J Korean Med Sci. 2005;20:721–726. doi: 10.3346/jkms.2005.20.5.721. [PMC free article] [PubMed] [CrossRef[]
23. Clinical pharmacology and biopharmaceutics review NDA 21-492 SE8-S008. https://www.fda.gov/files/drugs/published/N21492s008-Oxaliplatin-Clinpharm-BPCA.pdf
24. Cascinu S, Cordella L, Del Ferro E, et al. Neuroprotective effect of reduced glutathione on cisplatin-based chemotherapy in advanced gastric cancer: a randomized double-blind placebo-controlled trial. J Clin Oncol. 1995;13:26–32. doi: 10.1200/JCO.1995.13.1.26. [PubMed] [CrossRef[]
25. Smyth JF, Bowman A, Perren T, et al. Glutathione reduces the toxicity and improves quality of life of women diagnosed with ovarian cancer treated with cisplatin: results of a double-blind, randomised trial. Ann Oncol. 1997;8:569–573. doi: 10.1023/A:1008211226339. [PubMed] [CrossRef[]
26. Cavaletti G, Frigeni B, Lanzani F, et al. The Total Neuropathy Score as an assessment tool for grading the course of chemotherapy-induced peripheral neurotoxicity: comparison with the National Cancer Institute-Common Toxicity Scale. J Peripher Nerv Syst. 2007;12:210–215. doi: 10.1111/j.1529-8027.2007.00141.x. [PubMed] [CrossRef[]
27. Kuroi K, Shimozuma K, Ohashi Y, et al. Prospective assessment of chemotherapy-induced peripheral neuropathy due to weekly paclitaxel in patients with advanced or metastatic breast cancer (CSP-HOR 02 study) Support Care Cancer. 2009;17:1071–1080. doi: 10.1007/s00520-008-0550-x. [PubMed] [CrossRef[]
28. Postma TJ, Heimans JJ, Muller MJ, et al. Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy. Ann Oncol. 1998;9:739–744. doi: 10.1023/A:1008344507482. [PubMed] [CrossRef[]
29. Haryani H, Fetzer SJ, Wu CL, et al. Chemotherapy-induced peripheral neuropathy assessment tools: a systematic review. Oncol Nurs Forum. 2017;44:E111–E123. doi: 10.1188/17.ONF.E111-E123. [PubMed] [CrossRef[]
30. Kopec JA, Land SR, Cecchini RS, et al. Validation of a self-reported neurotoxicity scale in patients with operable colon cancer receiving oxaliplatin. J Supp Oncol. 2006;4:W1–W8. []
31. Hausheer FH, Schilsky RL, Bain S, et al. Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy. Semin Oncol. 2006;33:15–49. doi: 10.1053/j.seminoncol.2005.12.010. [PubMed] [CrossRef[]
32. Yamada Y, Higuchi K, Nishikawa K, et al. Phase III study comparing oxaliplatin plus S-1 with cisplatin plus S-1 in chemotherapy-naïve patients with advanced gastric cancer. Ann Oncol. 2015;26:141–148. doi: 10.1093/annonc/mdu472. [PubMed] [CrossRef[]
33. Watanabe T, Muro K, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol. 2018;23:1–34. doi: 10.1007/s10147-017-1101-6. [PMC free article] [PubMed] [CrossRef[]




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