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Zwart NRK, Franken MD, Tissing WJE, Lubberman FJE, McKay JA, Kampman E, Kok DE. Folate, folic acid, and chemotherapy-induced toxicities: a systematic literature review. Crit Rev Oncol Hematol 2023:104061. [PMID: 37353179 DOI: 10.1016/j.critrevonc.2023.104061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/25/2023] Open
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 6,231 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.
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Affiliation(s)
- Nienke R K Zwart
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Mira D Franken
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Wim J E Tissing
- Prinses Máxima Centre for Pediatric Oncology, Utrecht, the Netherlands
| | - Floor J E Lubberman
- Department of Clinical Pharmacy, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Jill A McKay
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
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Rashidi FB, AlQhatani AD, Bashraheel SS, Shaabani S, Groves MR, Dömling A, Goda SK. Isolation and molecular characterization of novel glucarpidases: Enzymes to improve the antibody directed enzyme pro-drug therapy for cancer treatment. PLoS One 2018; 13:e0196254. [PMID: 29698433 PMCID: PMC5919439 DOI: 10.1371/journal.pone.0196254] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/09/2018] [Indexed: 11/19/2022] Open
Abstract
Repeated cycles of antibody-directed enzyme pro-drug therapy (ADEPT) and the use of glucarpidase in the detoxification of cytotoxic methotrexate (MTX) are highly desirable during cancer therapy but are hampered by the induced human antibody response to glucarpidase. Novel variants of glucarpidase (formal name: carboxypeptidase G2, CPG2) with epitopes not recognized by the immune system are likely to allow repeated cycles of ADEPT for effective cancer therapy. Towards this aim, over two thousand soil samples were collected and screened for folate hydrolyzing bacteria using folate as the sole carbon source. The work led to the isolation and the characterization of three new glucarpidase producing strains, which were designated as: Pseudomonas lubricans strain SF168, Stenotrophomonas sp SA and Xenophilus azovorans SN213. The CPG2 genes of Xenophilus azovorans SN213 (named Xen CPG2) and Stenotrophomonas sp SA (named Sten CPG2) were cloned and molecularly characterized. Both Xen CPG2 and Sten CPG2 share very close amino acid sequences (99%); we therefore, focused on the study of Xen CPG2. Finally, we demonstrated that a polyclonal antibody raised against our new CPG2, Xen CPG2, does not react with the CPG2 from Pseudomonas sp. strain RS-16 (Ps CPG2) that are currently in clinical use. The two enzymes, therefore could potentially be used consecutively in the ADEPT protocol to minimize the effect of the human antibody response that hampers current treatment with Ps CPG2. The identified novel CPG2 in this study will, therefore, pave the way for safer antibody directed enzyme pro-drug therapy for cancer treatment.
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Affiliation(s)
| | - Alanod D. AlQhatani
- Anti-doping Lab-Qatar, Research Department, Protein Engineering unit, Doha, Qatar
- Drug Design Group, Department of Pharmacy, University of Groningen, Antonius Deusinglaan, AV Groningen, The Netherlands
| | - Sara S. Bashraheel
- Anti-doping Lab-Qatar, Research Department, Protein Engineering unit, Doha, Qatar
- Drug Design Group, Department of Pharmacy, University of Groningen, Antonius Deusinglaan, AV Groningen, The Netherlands
| | - Shabnam Shaabani
- Drug Design Group, Department of Pharmacy, University of Groningen, Antonius Deusinglaan, AV Groningen, The Netherlands
| | - Matthew R. Groves
- Drug Design Group, Department of Pharmacy, University of Groningen, Antonius Deusinglaan, AV Groningen, The Netherlands
| | - Alexander Dömling
- Drug Design Group, Department of Pharmacy, University of Groningen, Antonius Deusinglaan, AV Groningen, The Netherlands
| | - Sayed K. Goda
- Cairo University, Faculty of Science, Giza, Egypt
- Anti-doping Lab-Qatar, Research Department, Protein Engineering unit, Doha, Qatar
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