|
|
Pharmacokinetic characteristics and clinical synergistic strategy of high-dose vitamin C against cancer |
Wang Shiwan, Wang Xin, Qu Jinxiu, He Jia, Zhao Yuan, Rao Benqiang |
Center for Oncology Nutrition and Metabolism Beijing Shijitan Hospital Capital Medical Univerisity / Key Laboratory of Cancer FSMP for
State Market Regulation Beijing 100038 China |
|
|
Abstract High - dose vitamin C HDVC therapy has synergistic or sensitizing effects on chemotherapy radiotherapy and
targeted therapy in preclinical experiments. However the clinical efficacy of HDVC is limited which shows that there is no significant
improvement in the prognosis of cancer patients. This may be related to the pharmacokinetic characteristics of vitamin C such as
Vitamin C is volatile that its half-life is only 30 minutes and is rapidly excreted through renal first-order kinetics also its effective
concentration duration of only a few hours. Thus after stopping infusion the plasma vitamin C concentration rapidly decreases
resulting in insufficient time for the drug to reach a peak concentration or maintain an effective concentration to kill tumor cells in the
body. As a cheap and low-toxicity anti-tumor therapy HDVC needs to find strategies to enhance its clinical efficacy. This article
summarizes the clinical efficacy enhancement strategies of HDVC from existing clinical trials by increasing blood concentrations
prolonging effective concentration durations and delaying drug metabolism which including adjusting the solvent using sterile water
as the preferred preparation preparing it on site and sealing it with vacuum standardizing the dosing schedule and recommending a
single dose of 75-100 g 1. 5-2. 2 g / kg administered intravenously at a constant speed of 1g / min for at least 3 times per week for 4
weeks or longer. Nanotechnology and combining with arsenic trioxide or FOLFOX can also enhance the clinical efficacy of
HDVC. These strategies provide ideas and references for the standardized clinical application of HDVC in the future.
|
Received: 20 December 2023
|
|
|
|
|
|
|