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Robitaille K, Guertin MH, Jamshidi A, Xu HW, Hovington H, Pelletier JF, Beaudoin L, Gevariya N, Lacombe L, Tiguert R, Caumartin Y, Dujardin T, Toren P, Lodde M, Racine É, Trudel D, Perigny M, Duchesne T, Savard J, Julien P, Fradet Y, Fradet V. A phase IIb randomized placebo-controlled trial testing the effect of MAG-EPA long-chain omega-3 fatty acid dietary supplement on prostate cancer proliferation. COMMUNICATIONS MEDICINE 2024; 4:56. [PMID: 38519581 PMCID: PMC10960033 DOI: 10.1038/s43856-024-00456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 02/07/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND High prostate eicosapentaenoic fatty acid (EPA) levels were associated with a significant reduction of upgrading to grade group (GG) ≥ 2 prostate cancer in men under active surveillance. We aimed to evaluate the effect of MAG-EPA long-chain omega-3 fatty acid dietary supplement on prostate cancer proliferation. METHODS A phase II double-blind randomized placebo-controlled trial was conducted in 130 men diagnosed with GG ≥ 2 prostate cancer and undergoing radical prostatectomy between 2015-2017 (Clinicaltrials.gov: NCT02333435). Participants were randomized to receive 3 g daily of either MAG-EPA (n = 65) or placebo (n = 65) for 7 weeks (range 4-10) prior to radical prostatectomy. The primary outcome was the cancer proliferation index quantified by automated image analysis of tumor nuclear Ki-67 expression using standardized prostatectomy tissue microarrays. Additional planned outcomes at surgery are reported including plasma levels of 27 inflammatory cytokines and fatty acid profiles in circulating red blood cells membranes and prostate tissue. RESULTS Cancer proliferation index measured by Ki-67 expression was not statistically different between the intervention (3.10%) and placebo (2.85%) groups (p = 0.64). In the per protocol analyses, the adjusted estimated effect of MAG-EPA was greater but remained non-significant. Secondary outcome was the changes in plasma levels of 27 cytokines, of which only IL-7 was higher in MAG-EPA group compared to placebo (p = 0.026). Men randomized to MAG-EPA prior to surgery had four-fold higher EPA levels in prostate tissue compared to those on placebo. CONCLUSIONS This MAG-EPA intervention did not affect the primary outcome of prostate cancer proliferation according to nuclear Ki-67 expression. More studies are needed to decipher the effects of long-chain omega-3 fatty acid dietary supplementation in men with prostate cancer.
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Affiliation(s)
- Karine Robitaille
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, G1V 0A6, Canada
| | - Marie-Hélène Guertin
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Afshin Jamshidi
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
| | - Hui Wen Xu
- Department of Mathematics and Statistics, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Hélène Hovington
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
| | | | - Lisanne Beaudoin
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
| | - Nikunj Gevariya
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
| | - Louis Lacombe
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Rabi Tiguert
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Yves Caumartin
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Thierry Dujardin
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Paul Toren
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Michele Lodde
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
| | - Étienne Racine
- Department of Pathology, CHU de Québec-Université Laval, Québec, QC, G1R 2J6, Canada
| | - Dominique Trudel
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) et Institut du cancer de Montréal, and Department of Pathology and Cellular Biology, Université de Montréal, Montréal, H3C 3J7, Canada
| | - Martine Perigny
- Department of Pathology, CHU de Québec-Université Laval, Québec, QC, G1R 2J6, Canada
| | - Thierry Duchesne
- Department of Mathematics and Statistics, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Josée Savard
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- School of psychology, Université Laval, Montréal, QC, G1R 2J6, Canada
| | - Pierre Julien
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Yves Fradet
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada
- Faculty of Medicine, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Vincent Fradet
- CHU de Québec-Université Laval Research Center, Québec, QC, G1R 3S1, Canada.
- Centre de recherche sur le Cancer de l'Université Laval, Québec, QC, G1R 3S3, Canada.
- Institute of nutrition and functional foods (INAF) and NUTRISS Center - Nutrition, health and society of Université Laval, Québec, G1V 0A6, Canada.
- Centre de Recherche Clinique et Évaluative en Oncologie de L'Hôtel-Dieu de Québec, CHU de Québec-Université Laval, Québec, QC, G1R 3S1, Canada.
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Powers-James C, Morse M, Narayanan S, Ramondetta L, Lopez G, Wagner R, Cohen L. Integrative Oncology Approaches to Reduce Recurrence of Disease and Improve Survival. Curr Oncol Rep 2024; 26:147-163. [PMID: 38180690 DOI: 10.1007/s11912-023-01467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE OF REVIEW After a cancer diagnosis, patients ask what they can do in addition to the recommended treatments to increase their survival. Many turn to integrative medicine modalities and lifestyle changes to improve their chances of survival. Numerous studies have demonstrated that lifestyle changes can significantly improve survival rates for cancer patients. Less support exists for the use of natural products or supplements to improve cancer survival. In this manuscript, we review key findings and evidence in the areas of healthy eating habits, physical activity, stress management and social support, and sleep quality, as well as natural products and supplements as they relate to the cancer recurrence and survival. RECENT FINDINGS While more research is needed to fully understand the mechanisms underlying the associations between lifestyle changes and cancer survival, findings suggest that lifestyle modifications in the areas of diet, physical activity, stress management and social support, and sleep quality improve clinical cancer outcomes. This is especially true for programs that modify more than one lifestyle habit. To date, outside of supplementing with vitamin D to maintain adequate levels, conflicting conclusion within the research remain regarding the efficacy of using natural products or supplement to improve cancer recurrence of disease or cancer survival. A call for further research is warranted. Lifestyle screening and counseling should be incorporated into cancer treatment plans to help improve patient outcomes. While the scientific community strives for the pursuit of high-quality research on natural products to enhance cancer survival, transparency, dialogue, and psychological safety between patients and clinicians must continue to be emphasized. Proactive inquiry by clinicians regarding patients' supplement use will allow for an informed discussion of the benefits and risks of natural products and supplements, as well as a re-emphasis of the evidence supporting diet and other lifestyle habits to increase survival.
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Affiliation(s)
- Catherine Powers-James
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | - Meroë Morse
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Santhosshi Narayanan
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lois Ramondetta
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Gabriel Lopez
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Richard Wagner
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
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Farvid MS, Spence ND, Rosner BA, Barnett JB, Holmes MD. Associations of low-carbohydrate diets with breast cancer survival. Cancer 2023; 129:2694-2704. [PMID: 37300441 PMCID: PMC10441613 DOI: 10.1002/cncr.34819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/01/2023] [Accepted: 03/22/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The objective of this study was to evaluate the role of low-carbohydrate diets after breast cancer diagnosis in relation to breast cancer-specific and all-cause mortality. METHODS For 9621 women with stage I-III breast cancer from two ongoing cohort studies, the Nurses' Health Study and Nurses' Health Study II, overall low-carbohydrate, animal-rich low-carbohydrate, and plant-rich low-carbohydrate diet scores were calculated by using food frequency questionnaires collected after breast cancer diagnosis. RESULTS Participants were followed up for a median 12.4 years after breast cancer diagnosis. We documented 1269 deaths due to breast cancer and 3850 all-cause deaths. With the use of Cox proportional hazards regression and after controlling for potential confounding variables, we observed a significantly lower risk of overall mortality among women with breast cancer who had greater adherence to overall low-carbohydrate diets (hazard ratio for quintile 5 vs. quintile 1 [HRQ5vsQ1 ], 0.82; 95% CI, 0.74-0.91; ptrend = .0001) and plant-rich low-carbohydrate diets (HRQ5vsQ1 , 0.73; 95% CI, 0.66-0.82; ptrend < .0001) after breast cancer diagnosis but not animal-rich low-carbohydrate diets (HRQ5vsQ1 , 0.93; 95% CI, 0.84-1.04; ptrend = .23). However, greater adherence to overall, animal-rich, or plant-rich low-carbohydrate diets was not significantly associated with a lower risk of breast cancer-specific mortality. CONCLUSIONS This study showed that greater adherence to low-carbohydrate diets, especially plant-rich low-carbohydrate diets, was associated with better overall survival but not breast cancer-specific survival among women with stage I-III breast cancer.
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Affiliation(s)
- Maryam S Farvid
- Data Statistics Group, Mission Viejo, California, USA
- Health and Healing Research Education and Service, Boston, Massachusetts, USA
| | - Nicholas D Spence
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto, Toronto, Ontario, Canada
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Junaidah B Barnett
- Health and Healing Research Education and Service, Boston, Massachusetts, USA
| | - Michelle D Holmes
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Karmokar PF, Moniri NH. Free-fatty acid receptor-1 (FFA1/GPR40) promotes papillary RCC proliferation and tumor growth via Src/PI3K/AKT/NF-κB but suppresses migration by inhibition of EGFR, ERK1/2, STAT3 and EMT. Cancer Cell Int 2023; 23:126. [PMID: 37355607 DOI: 10.1186/s12935-023-02967-x] [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: 05/08/2023] [Accepted: 06/07/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Papillary renal cell carcinoma (pRCC) is a highly metastatic genitourinary cancer and is generally irresponsive to common treatments used for the more prevalent clear-cell (ccRCC) subtype. The goal of this study was to examine the novel role of the free fatty-acid receptor-1 (FFA1/GPR40), a cell-surface expressed G protein-coupled receptor that is activated by medium-to-long chained dietary fats, in modulation of pRCC cell migration invasion, proliferation and tumor growth. METHODS We assessed the expression of FFA1 in human pRCC and ccRCC tumor tissues compared to patient-matched non-cancerous controls, as well as in RCC cell lines. Using the selective FFA1 agonist AS2034178 and the selective FFA1 antagonist GW1100, we examined the role of FFA1 in modulating cell migration, invasion, proliferation and tumor growth and assessed the FFA1-associated intracellular signaling mechanisms via immunoblotting. RESULTS We reveal for the first time that FFA1 is upregulated in pRCC tissue compared to patient-matched non-cancerous adjacent tissue and that its expression increases with pRCC cancer pathology, while the inverse is seen in ccRCC tissue. We also show that FFA1 is expressed in the pRCC cell line ACHN, but not in ccRCC cell lines, suggesting a unique role in pRCC pathology. Our results demonstrate that FFA1 agonism promotes tumor growth and cell proliferation via c-Src/PI3K/AKT/NF-κB and COX-2 signaling. At the same time, agonism of FFA1 strongly inhibits migration and invasion, which are mechanistically mediated via inhibition of EGFR, ERK1/2 and regulators of epithelial-mesenchymal transition. CONCLUSIONS Our data suggest that FFA1 plays oppositional growth and migratory roles in pRCC and identifies this receptor as a potential target for modulation of pathogenesis of this aggressive cancer.
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Affiliation(s)
- Priyanka F Karmokar
- Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University Health Sciences Center, Mercer University, 3001, Mercer University Drive, Atlanta, GA, 30341, USA
| | - Nader H Moniri
- Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University Health Sciences Center, Mercer University, 3001, Mercer University Drive, Atlanta, GA, 30341, USA.
- Department of Biomedical Sciences, School of Medicine, Mercer University Health Sciences Center, Mercer University, Macon, GA, 31207, USA.
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