Folate, folic acid, and chemotherapy-induced toxicities: A systematic literature review

Crit Rev Oncol Hematol. 2023 Aug:188:104061. doi: 10.1016/j.critrevonc.2023.104061. Epub 2023 Jun 21.

Abstract

Folate metabolism is a target for various chemotherapeutic drugs. Folate and its synthetic variant folic acid are B-vitamins. To what extent these vitamins impact treatment tolerance in patients with cancer remains unclear. A systematic literature review was conducted on intake and status of folate and folic acid in relation to chemotherapy-induced toxicities in children and adults with cancer. A total of 6231 publications were identified, of which 40 publications met the inclusion criteria. In 12 out of 22 studies focusing on antifolates, a deficient folate status and lower folate and folic acid intake were associated with a higher risk of toxicities. In 8 out of 14 studies focusing on fluoropyrimidine treatments, a higher folate status and intake were associated with a higher risk of toxicities. These findings might explain interindividual differences in treatment tolerance and highlight the importance of evaluating nutritional status in oncology care.

Keywords: Cancer; Chemotherapy; Folate; Folic acid; Toxicity.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents* / adverse effects
  • Child
  • Dietary Supplements
  • Folic Acid / metabolism
  • Folic Acid / therapeutic use
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / metabolism
  • Nutritional Status
  • Vitamin B Complex* / therapeutic use

Substances

  • Folic Acid
  • Vitamin B Complex
  • Antineoplastic Agents