Pharmacological Ascorbate Enhances Chemotherapies in Pancreatic Ductal Adenocarcinoma

Pancreas. 2022 Jul 1;51(6):684-693. doi: 10.1097/MPA.0000000000002086. Epub 2022 Sep 13.

Abstract

Objectives: Pharmacological ascorbate (P-AscH - , high-dose, intravenous vitamin C) has shown promise as an adjuvant therapy for pancreatic ductal adenocarcinoma (PDAC) treatment. The objective of this study was to determine the effects of P-AscH - when combined with PDAC chemotherapies.

Methods: Clonogenic survival, combination indices, and DNA damage were determined in human PDAC cell lines treated with P-AscH - in combination with 5-fluorouracil, paclitaxel, or FOLFIRINOX (combination of leucovorin, 5-fluorouracil, irinotecan, oxaliplatin). Tumor volume changes, overall survival, blood analysis, and plasma ascorbate concentration were determined in vivo in mice treated with P-AscH - with or without FOLFIRINOX.

Results: P-AscH - combined with 5-fluorouracil, paclitaxel, or FOLFIRINOX significantly reduced clonogenic survival in vitro. The DNA damage, measured by γH2AX protein expression, was increased after treatment with P-AscH - , FOLFIRINOX, and their combination. In vivo, tumor growth rate was significantly reduced by P-AscH - , FOLFIRINOX, and their combination. Overall survival was significantly increased by the combination of P-AscH - and FOLFIRINOX. Treatment with P-AscH - increased red blood cell and hemoglobin values but had no effect on white blood cell counts. Plasma ascorbate concentrations were significantly elevated in mice treated with P-AscH - with or without FOLFIRINOX.

Conclusions: The addition of P-AscH - to standard of care chemotherapy has the potential to be an effective adjuvant for PDAC treatment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antineoplastic Agents* / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Ascorbic Acid / pharmacology
  • Carcinoma, Pancreatic Ductal* / drug therapy
  • Fluorouracil
  • Humans
  • Irinotecan / pharmacology
  • Irinotecan / therapeutic use
  • Leucovorin / pharmacology
  • Leucovorin / therapeutic use
  • Mice
  • Oxaliplatin / pharmacology
  • Oxaliplatin / therapeutic use
  • Paclitaxel
  • Pancreatic Neoplasms* / drug therapy
  • Pancreatic Neoplasms* / genetics
  • Pancreatic Neoplasms* / metabolism

Substances

  • Antineoplastic Agents
  • Oxaliplatin
  • Irinotecan
  • Paclitaxel
  • Ascorbic Acid
  • Leucovorin
  • Fluorouracil