New Delhi: Scientists and researchers associated with the country’s premier Tata Memorial Centre (TMC) claim to have found a novel nutraceutical that may significantly reduce the toxicity related to cancer treatment and also bring down the rate of cancer recurrence.
Nutraceutical is any product derived from food sources with health benefits yet to be scientifically confirmed.
Earlier this month, Dr Indraneel Mittra, a cancer researcher with the Mumbai-based hospital’s research and development wing, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), and colleagues published the results of the RESCU 001 study.
The findings suggested that giving resveratrol, along with miniscule doses of copper, reduced toxicity in patients receiving stem cell transplant for multiple myeloma — a type of cancer that starts from plasma cells in the blood. Resveratrol is known to have anti-inflammatory and immunomodulating properties, among others.
This reaffirms evidence from other studies carried out by scientists at the institute suggesting that the use of resveratrol, a commonly used health supplement, when given with copper (R+Cu) can bring down the rate of treatment related toxicity in cancer patients by up to 50 percent.
Findings from an animal study, for instance, have shown that the adjunct therapy with resveratrol and copper (R+Cu) can reduce the rate of metastasis by nearly 30 percent, scientists from the ACTREC told ThePrint.
The results, however, need to be confirmed in a large randomised clinical trial in cancer patients, which the institute plans to start soon.
“The results from our ongoing studies are of immense significance as not only have we been able to develop greater understanding of the mechanism of metastasis, we have also found a way to curb it which can be beneficial for many patients,” said a senior scientist from the ACTREC.
“We will, however, need to validate the findings in a high number of cancer patients which may take 5-6 years from now,” the scientist added.
ThePrint reached Tata Memorial Centre director Dr Sudeep Gupta via call but had not received a response by the time of publication. This report will be updated if and when a response is received.
Some independent cancer experts, however, stressed that the results, though interesting, should be seen with a pinch of salt and need to be validated with detailed analysis.
Dr Kamal Veer Singh Saini, a UK-based medical oncologist and cancer researcher associated with the University of Cambridge, said the line of research raises two crucial questions: whether some methods or types of anticancer treatment increase chances of the cancer spreading and can some herbal or food supplements help improve clinical outcomes in patients with cancer?
“It would be interesting to see these findings corroborated independently by other laboratories around the world, and further research conducted in this field,” said Saini who is also executive director of Fortrea, a leading clinical research company.
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Promising signs, but a long way to go
A unique but menacing property that cancer cells possess is that they can occasionally spread from the primary site to other sites in the body through a process called metastasis that can be difficult to treat.
But now, a growing body of research suggests that dying cancer cells release cell-free chromatin particles (cfChPs, or fragments of chromosomes) which can turn healthy cells into cancerous ones. Some cfChPs may fuse with healthy chromosomes and cause new tumours, Mittra was quoted as saying by the Press Information Bureau (PIB).
A study which came out in April last year examined whether chemotherapy, radiotherapy, or surgery, which generate dying cancer cells, could contribute to the cancer’s metastatic spread.
To do this, researchers led by Mittra grafted human breast cancer cells in immune-deficient mice to generate tumours. The mice then received treatment in the form of chemotherapy, radiotherapy, or surgery and half of them also received agents that deactivate or destroy cfChPs.
The researchers not only found the presence of human DNA (cfChPs) and cancer proteins in the mice brains, but observed that these had increased markedly after treatment, especially after chemotherapy and radiotherapy.
However, mice that received compounds to deactivate or destroy cfChPs- containing resveratrol — found in grapes, peanuts and cocoa and known for anti-ageing properties — had minimal human cfChPs in their brains.
Based on these findings, the researchers speculated that cfChPs which may contain cancer-causing genes, and which have the ability to migrate through the bloodstream to enter healthy cells in other organs, may cause the metastatic spread of cancer.
Importantly, the administration of cfChP-deactivating or destroying agents, in this case R+Cu, prevented their invasion into healthy cells thereby potentially preventing metastatic spread.
The peer reviewed study published this month and carried out on 25 patients with multiple myeloma, showed that stem cell transplant-related toxicities were lesser in those who received the nutraceutical.
“This is a well conducted study but needs to be replicated in a larger number of patients and in multiple centres,” Saini said, adding that this adds to a growing body of evidence that supplementation of specific nutraceuticals helps reduce toxicity.
“What would be more interesting to establish is whether the use of the R+Cu combination could also reduce chances of cancer recurrence. In summary, this is an interesting proof-of-concept trial and justifies running larger multi-centre follow-on studies to test this hypothesis further,” he added.
Asked to comment on the findings, Dr Rajeev Jayadevan, a Cochin-based medical researcher, told ThePrint, “The research is interesting. The authors believe that a nutraceutical containing copper and resveratrol could potentially reduce the chance of metastasis or distant spread of cancer, and also reduce side effects of chemotherapy and radiation.”
“However the research pertaining to metastasis is done on mice and the findings are speculative at this time about whether it will effectively stop metastasis in humans. A small trial on humans with myeloma did reduce some, but not all side effects of chemotherapy. Larger randomised controlled trials on humans will shed more light in this direction.”
The ACTREC scientist quoted above, meanwhile, remarked that a parallel application had been moved to the Central Drugs Standard Control Organisation (CDSCO) for approval of R+Cu as a nutraceutical and it could be available in the market within the next few months.
“Its price is expected to be well under Rs 100 per tablet once available,” the scientist said, adding that if successful the adjunct therapy would help patients with various types of cancers.
But, he cautioned, whether the results seen so far will translate to real world outcomes for people with cancer and what toxicities could occur from its pro-oxidant, DNA-damaging effect, is yet to be determined.
Saini meanwhile, pointed out that nutraceutical studies are difficult to design, since the human system is extremely complex.
Sequencing or combination of agents, pharmacogenetics (effects of genes on response to medicines), epigenetics (effect of behaviour and environment on genes), microbiome and circadian rhythms — all impact the response of a patient to anti-cancer therapy, and taking apart these individual strands via well-designed and conducted randomised trials is extremely challenging, he underlined.
(Edited by Amrtansh Arora)
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