The nutrient folate is essential for normal cell growth and development.
Enzymes that require folate as a cofactor have been common targets for
chemotherapeutic agents. Limited clinical guidance is available regarding
optimal levels of dietary or supplemental folate intake during antifolate
chemotherapy to meet the goals of minimizing treatment-related toxicity yet
preserving treatment effectiveness. Patients with higher folate intake may
experience less treatment-related toxicities; however, the concern is that
folate may interfere with the effectiveness of the antifolate treatment and
possibly support tumor growth. This article will review folate and antifolate
metabolism and review the current body of knowledge regarding the interactions
between folates and antifolates. Future research in this area should include
evaluation of pretreatment folate status and dietary and supplemental folate
intake before, during, and after treatment.
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