GRAND RAPIDS, MI — Adding Vitamin C may improve the effectiveness of treatments currently given to patients with some forms of leukemia.
That’s the finding of a new study, co-authored by top scientists at the Van Andel Research Institute in Grand Rapids, published Monday, Aug. 29, in the Proceedings of the National Academy of Sciences.
The study indicates the vitamin – found naturally in citrus fruits and leafy green vegetables — when given in pill form may improve the effectiveness of the standard treatment for myeloid dysplastic syndrome, or MDS, and acute myeloid leukemia, or AML.
An estimated 13,000 people in the U.S. are diagnosed with MDS annually and about 20,000 are diagnosed with AML. Currently, only about half of patients with MDS and AML respond to the epigenetic therapy alone.
“If the pilot trial is successful, we plan to pursue a larger trial to explore this strategy’s potential as a straightforward and cost-effective way to improve the existing therapy for AML and MDS,” Peter Jones, co-senior author of the study, said in a statement.
Jones is the chief scientific officer at Van Andel Research Institute and co-leader of the Van Andel Research Institute – Stand Up To Cancer, or VARI – SU2C, Epigenetics Dream Team with Dr. Stephen Baylin, who is co-head of Cancer Biology at Johns Hopkins University’s Sidney Kimmel Comprehensive Cancer Center.
Their work confirms what some cancer investigators have observed over the years: those with cancer or receiving treatments have low Vitamin C levels, Baylin told MLive and The Grand Rapids Rapids Press.
In the last decade, the Food and Drug Administration has approved epigenetic therapies that work to correct errors in cancer cells.
Initial lab studies indicate that supplementing an epigenetic cancer drug called decitabine with vitamin C enhanced the drug’s ability to impede cancer cell growth and trigger cellular self-destruction in cancer cell lines.
A pilot clinical trial based on this work is ongoing in adult patients with MDS or AML at one of Denmark’s largest hospitals in Copenhagen. It combines a similar drug called azacitidine — the standard of care therapy — with vitamin C.
Many cancer patients are deficient in vitamin C; the proposed approach seeks to correct this deficiency rather than overload patients with the vitamin, according to Jones.
The Stand Up To Cancer (VARI– SU2C) Epigenetics Dream Team, originally launched in 2009, came over to the Institute in 2014, when the Michigan research center committed $7.5 million to study epigenetic therapy in cancer treatment.
Stand Up to Cancer is a live biennial telecast that pairs celebrities and entertainers with scientists to raise funds for cancer research. The organization, co-founded by broadcast journalist Katie Couric and a group of women who work in the entertainment industry, emphasizes collaboration among scientists, rather than competition.
Researchers are delivering the good news about Vitamin C with a dose of caution.
Jones notes only a clinical trial that combines azacitidine with the blinded addition of either vitamin C or a placebo will give the true answer as to whether or not vitamin C is helpful in the treatments.
“At the same time, we must emphasize that our trial is limited to a certain subset of patients with MDS or AML on a specific therapeutic regimen,” Jones said. “We do not have evidence that this approach is appropriate for other cancers or chemotherapies.”
The proposed strategy reflects a continuing move toward combination therapies, particularly when it comes to epigenetic approaches, which target the mechanisms that control whether genes are switched on or off.
In cancer, these switches inappropriately activate or silence important genes, such as those that regulate cell growth and life cycle, ultimately leading to tumors.
The trial is led by Dr. Kirsten Grønbæk, chief hematologist and professor at University of Copenhagen’s Rigshospitalet Hospital and member of the VARI–SU2C Epigenetics Dream Team. The trial will include 20 patients. Preliminary results are expected by spring or summer 2017.
“This type of combination therapy is promising but more work is needed to determine its safety and efficacy,” Grønbæk said. “It is truly exciting to consider that there could be a simple and elegant approach to help patients fight MDS and AML. However, as a physician, I strongly urge patients to wait for the results of the clinical trial and to discuss all dietary and supplemental changes with their doctors.”
The research reported in the paper was conducted by Grønbæk and Jones’ teams in collaboration with Baylin and Dr. Gangning Liang, at University of Southern California’s Keck School of Medicine.
It is supported by the VARI–SU2C Epigenetics Dream Team, the National Cancer Institute, the Vicky Joseph Cancer Research Fund, the Novo Nordisk Foundation, the Danish Cancer Society and the Lundbeck Foundation.