Chemoprotection refers to the protection from the toxicity of one chemical by the intervention of another. Conflicting preclinical and clinical reports make it difficult to either ignore or accept the use of chemoprotectants during cancer chemotherapy or radiotherapy. The selection of anticancer drugs depends on the type and stage of cancer development. However, very little attention has been paid to the selection of chemoprotectants.The answer to the use of chemoprotectants during cancer therapy lies in their appropriate selection in a case-specific and/or issue-specific manner. The need of the hour is to find better answers on the rationality of chemoprotectants selection during cancer therapy using cutting-edge science. In this commentary, we have presented few examples to justify our view-points.
Herrera E., Jimenez R., Aruoma OI, et al. Aspects of antioxidant foods and supplements in health and disease . Nutr Rev.2009;67:S140-S144.
2.
Hodek P., Krizkova J., Burdova K., et al. Chemopreventive compounds: view from the other side. Chem Biol Interact. 2009;180:1-9.
3.
Nobili S., Lippi D., Witort E., et al. Natural compounds for cancer treatment and prevention. Pharmacol Res. 2009;59: 365-378.
4.
Bjelakovic G. , Nikolova D., Simonetti RG, et al. Systematic review: primary and secondary prevention of gastrointestinal cancers with antioxidant supplements. Aliment Pharmacol Ther. 2008;28:689-703.
5.
Bjelakovic G. , Nikolova D., Simonetti RG, et al. Antioxidant supplements for preventing gastrointestinal cancers. Cochrane Database Syst Rev.2008;(3):CD004183.
6.
Hardy MLDietary supplement use in cancer care: help or harm. Hematol Oncol Clin North Am. 2008;22:581-617.
7.
Finley JWProposed criteria for assessing the efficacy of cancer reduction by plant foods enriched in carotenoids, glucosinolates, polyphenols and selenocompounds . Ann Bot (Lond). 2005 ;95:1075-1096.
8.
Bairati I., Meyer F., Gelinas M., et al. Randomized trial of antioxidant vitamins to prevent acute adverse effects of radiation therapy in head and neck cancer patients. J Clin Oncol. 2005;23:5805-5813.
9.
Bairati I., Meyer F., Gelinas M., et al. A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients. J Natl Cancer Inst. 2005;97: 481-488.
10.
Bairati I., Meyer F., Jobin E., et al. Antioxidant vitamins supplementation and mortality: a randomized trial in head and neck cancer patients. Int J Cancer. 2006;119:2221-2224.
11.
Lesperance ML , Olivotto IA, Forde N., et al. Mega-dose vitamins and minerals in the treatment of non-metastatic breast cancer: an historical cohort study . Breast Cancer Res Treat. 2002 ;76:137-143.
12.
Creagan ET, Moertel CG, O’Fallon JR, et al. Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer: a controlled trial. N Engl J Med. 1979;301:687-690.
13.
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.
14.
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.
15.
Lissoni P., Chilelli M., Villa S., et al. Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial. J Pineal Res. 2003;35:12-15.
16.
Lissoni P., Barni S., Mandala M., et al. Decreased toxicity and increased efficacy of cancer chemotherapy using the pineal hormone melatonin in metastatic solid tumour patients with poor clinical status. Eur J Cancer. 1999;35:1688-1692.
17.
Conklin KAChemotherapy-associated oxidative stress: impact on chemotherapeutic effectiveness . Integr Cancer Ther. 2004;3:294-300.
18.
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.
19.
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.
20.
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.
21.
Myers C., Bonow R., Palmeri S., et al. A randomized controlled trial assessing the prevention of doxorubicin cardiomyopathy by N-acetylcysteine. Semin Oncol. 1983;10:53-55.
22.
Pathak AK, Bhutani M., Guleria R., et al. Chemotherapy alone vs. chemotherapy plus high dose multiple antioxidants in patients with advanced non small cell lung cancer. J Am Coll Nutr. 2005;24:16-21.
23.
Weijl NI, Elsendoorn TJ, Lentjes EG, et al. Supplementation with antioxidant micronutrients and chemotherapy-induced toxicity in cancer patients treated with cisplatin-based chemotherapy: a randomised, double-blind, placebo-controlled study. Eur J Cancer. 2004;40:1713-1723.
24.
Pace A., Savarese A., Picardo M., et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol. 2003;21:927-931.
25.
Zunino F., Pratesi G., Micheloni A., et al. Protective effect of reduced glutathione against cisplatin-induced renal and systemic toxicity and its influence on the therapeutic activity of the antitumor drug. Chem Biol Interact. 1989;70: 89-101.
26.
D’Andrea GMUse of antioxidants during chemotherapy and radiotherapy should be avoided. CA Cancer J Clin. 2005;55: 319-321.
27.
Labriola D. , Livingston R.Possible interactions between dietary antioxidants and chemotherapy. Oncology. 1999 ;13: 1003-1008; discussion 1008, 1011-1002.
28.
Simone CB II , Simone NL, Simone V., et al. Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 1. Altern Ther Health Med. 2007;13:22-28.
29.
Prasad KNMultiple dietary antioxidants enhance the efficacy of standard and experimental cancer therapies and decrease their toxicity. Integr Cancer Ther. 2004;3:310-322.
30.
Chinery R., Brockman JA, Peeler MO, et al. Antioxidants enhance the cytotoxicity of chemotherapeutic agents in colorectal cancer: a p53-independent induction of p21WAF1/CIP1 via C/EBPbeta . Nat Med. 1997;3:1233-1241.
31.
Hofmann J., Fiebig HH, Winterhalter BR, et al. Enhancement of the antiproliferative activity of cis-diamminedichloroplatinum(II) by quercetin. Int J Cancer. 1990;45:536-539.
32.
Simone CB II , Simone NL, Simone V., et al. Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 2. Altern Ther Health Med. 2007;13:40-47.
33.
Block KI, Koch AC, Mead MN, et al. Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomized controlled trials. Int J Cancer. 2008;123:1227-1239.
Wiernik PH, Schiffer CALong-term follow-up of advanced Hodgkin’s disease patients treated with a combination of streptozotocin, lomustine (CCNU), doxorubicin and bleomycin (SCAB). J Cancer Res Clin Oncol. 1988;114:105-107.
36.
Modak MA, Datar SP, Bhonde RR, et al. Differential susceptibility of chick and mouse islets to streptozotocin and its co-relation with islet antioxidant status. J Comp Physiol B. 2007;177:247-257.
37.
Vikram A., Tripathi DN, Ramarao P., et al. Intervention of D-glucose ameliorates the toxicity of streptozotocin in accessory sex organs of rat. Toxicol Appl Pharmacol. 2008;226: 84-93.
Korkmaz A., Oter S., Sadir S., et al. Peroxynitrite may be involved in bladder damage caused by cyclophosphamide in rats. J Urol. 2005;173:1793-1796.
40.
Jia L., Zhang Z., Zhai L., et al. Protective effect of lipoic acid against acrolein-induced cytotoxicity in IMR-90 human fibroblasts. J Nutr Sci Vitaminol ( Tokyo). 2009;55:126-130.
41.
Tanel A., Averill-Bates DAInhibition of acrolein-induced apoptosis by the antioxidant N-acetylcysteine . J Pharmacol Exp Ther. 2007;321:73-83.
42.
Scambia G., Ranelletti FO, Benedetti Panici P., et al. Inhibitory effect of quercetin on primary ovarian and endometrial cancers and synergistic activity with cis-diamminedichloroplatinum (II). Gynecol Oncol. 1992;45:13-19.
43.
Lewis C.A review of the use of chemoprotectants in cancer chemotherapy. Drug Saf. 1994;11:153-162.
44.
Klein P., Muggia FMCytoprotection: shelter from the storm. Oncologist . 1999;4:112-121.
45.
Sasse AD, Clark LG, Sasse EC, et al. Amifostine reduces side effects and improves complete response rate during radiotherapy: results of a meta-analysis. Int J Radiat Oncol Biol Phys. 2006;64:784-791.
46.
Neuwelt EA, Pagel MA, Kraemer DF, et al. Bone marrow chemoprotection without compromise of chemotherapy efficacy in a rat brain tumor model. J Pharmacol Exp Ther . 2004;309:594-599.
47.
Rodrigues MJ , Bouyon A., Alexandre J.Role of antioxidant complements and supplements in oncology in addition to an equilibrate regimen: a systematic review. Bull Cancer. 2009;96:677-684.
48.
Demoor-Goldschmidt C., Raynard B.How can we integrate nutritional support in medical oncology? Bull Cancer. 2009;96:665-675.
49.
Krzystyniak KLCurrent strategies for anticancer chemoprevention and chemoprotection. Acta Pol Pharm. 2002;59:473-478.
50.
Myzak MC, Dashwood RHChemoprotection by sulforaphane: keep one eye beyond Keap1. Cancer Lett. 2006;233:208-218.
51.
Aardema MJ, MacGregor JTToxicology and genetic toxicology in the new era of "toxicogenomics": impact of "-omics" technologies. Mutat Res. 2002;499:13-25.
52.
Kondo C., Minowa Y., Uehara T., et al. Identification of genomic biomarkers for concurrent diagnosis of drug-induced renal tubular injury using a large-scale toxicogenomics database . Toxicology. 2009;265:15-26.
53.
Kong FM, Ao X., Wang L., et al. The use of blood biomarkers to predict radiation lung toxicity: a potential strategy to individualize thoracic radiation therapy. Cancer Control. 2008;15:140-150.
54.
Kulkarni K. , Larsen P., Linninger AAAssessing chronic liver toxicity based on relative gene expression data. J Theor Biol . 2008;254:308-318.
55.
Shi W., Bugrim A., Nikolsky Y., et al. Characteristics of genomic signatures derived using univariate methods and mechanistically anchored functional descriptors for predicting drug- and xenobiotic-induced nephrotoxicity. Toxicol Mech Methods. 2008;18:267-276.
56.
Ge F., He QYGenomic and proteomic approaches for predicting toxicity and adverse drug reactions. Expert Opin Drug Metab Toxicol. 2009;5:29-37.
57.
Matkovics A.Recent changes in concepts of antioxidant treatment [in Hungarian]. Orv Hetil. 2006;147:747-752.
58.
Frei B.Efficacy of dietary antioxidants to prevent oxidative damage and inhibit chronic disease. J Nutr. 2004;134:3196S-3198S.
59.
Bandara LR, Kennedy S.Toxicoproteomics: a new preclinical tool. Drug Discov Today . 2002;7:411-418.
