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Ekeuku SO, Etim EP, Pang KL, Chin KY, Mai CW. Vitamin E in the management of pancreatic cancer: A scoping review. World J Gastrointest Oncol 2023; 15:943-958. [PMID: 37389119 PMCID: PMC10302993 DOI: 10.4251/wjgo.v15.i6.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/03/2023] [Accepted: 04/07/2023] [Indexed: 06/14/2023] Open
Abstract
Pancreatic cancer is the leading cause of cancer mortality worldwide. Research investigating effective management strategies for pancreatic cancer is ongoing. Vitamin E, consisting of both tocopherol and tocotrienol, has demonstrated debatable effects on pancreatic cancer cells. Therefore, this scoping review aims to summarize the effects of vitamin E on pancreatic cancer. In October 2022, a literature search was conducted using PubMed and Scopus since their inception. Original studies on the effects of vitamin E on pancreatic cancer, including cell cultures, animal models and human clinical trials, were considered for this review. The literature search found 75 articles on this topic, but only 24 articles met the inclusion criteria. The available evidence showed that vitamin E modulated proliferation, cell death, angiogenesis, metastasis and inflammation in pancreatic cancer cells. However, the safety and bioavailability concerns remain to be answered with more extensive preclinical and clinical studies. More in-depth analysis is necessary to investigate further the role of vitamin E in the management of pancreatic cancers.
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Affiliation(s)
- Sophia Ogechi Ekeuku
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Effiong Paul Etim
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
| | - Kok-Lun Pang
- Newcastle University Medicine Malaysia, Iskandar Puteri 79200, Johor, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Chun-Wai Mai
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur 56000, Malaysia
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Goyal H, Perisetti A, Rahman MR, Levin A, Lippi G. Vitamin D and Gastrointestinal Cancers: A Narrative Review. Dig Dis Sci 2019; 64:1098-1109. [PMID: 30511197 DOI: 10.1007/s10620-018-5400-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/27/2018] [Indexed: 12/14/2022]
Abstract
Calcitriol (1,25(OH)2D3) performs various activities throughout the body. Although low serum 25-hydroxyvitamin D [25(OH)D] levels are associated with several disease processes such as risk of fractures and falls, hypertension, cardiovascular disease, and diabetes mellitus, recent evidence attests that this important hormone also regulates several cellular pathways involved in cancer development and progression. Calcitriol modulates several genes controlling gut physiology and calcium homeostasis and also maintains the integrity of epithelial barriers, regulates the absorption of phosphate and calcium, and modulates host defense against pathogens and inflammatory response by interplaying with several types of secretory and immune cells. Vitamin D deficiency is significantly related to increased risk of developing certain types of cancer. This deficiency can be prevented by vitamin D supplementation which is both economical and safe. This can lower the risk of developing cancer and also improve the prognosis of patients with gastrointestinal malignancy, but epidemiological data remain inconsistent. Several retrospective observational studies have demonstrated the benefits of vitamin D supplementation, but a few randomized controlled trials have not seemingly supported the beneficial role of vitamin D supplementation in gastrointestinal cancers. Therefore, in this literature review, we aimed to examine the possible role of vitamin D in gastrointestinal malignancies, including gastric, esophageal, pancreatic, hepatic, and colorectal cancers.
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Affiliation(s)
- Hemant Goyal
- Mercer University School of Medicine, 707 Pine St, Macon, GA, 31201, USA.
| | - Abhilash Perisetti
- University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA
| | - M Rubayat Rahman
- University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA
| | - Avi Levin
- Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Hepatocellular carcinomas are promoted by tocopheryl acetate but eliminated by tocopheryl succinate. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2018. [DOI: 10.1016/j.jnim.2018.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Zhang X, Huang XZ, Chen WJ, Wu J, Chen Y, Wu CC, Wang ZN. Plasma 25-hydroxyvitamin D levels, vitamin D intake, and pancreatic cancer risk or mortality: a meta-analysis. Oncotarget 2017; 8:64395-64406. [PMID: 28969079 PMCID: PMC5610011 DOI: 10.18632/oncotarget.18888] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/04/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The associations between vitamin D status, including plasma 25-hydroxyvitamin D [25(OH)D] levels and vitamin D intake, and pancreatic cancer risk and mortality are inconsistent. The aims of this study are to evaluate the antitumor and therapeutic effects of vitamin D status for pancreatic cancer patients. METHODS A literature search for relevant studies was conducted using PubMed and Embase databases. Risk ratio (RR), hazard ratio (HR), and 95% confidence interval (CI) were used as the effect measures. All statistical analyses were performed using Stata software 12.0. RESULTS Our results indicated that high plasma 25(OH)D levels were inversely associated with pancreatic cancer mortality without significant heterogeneity (HR=0.81, 95% CI=0.68-0.96). However, high plasma 25(OH)D levels could not reduce pancreatic cancer risk (RR=1.02, 95% CI=0.66-1.57). Moreover, vitamin D intake was also not associated with pancreatic cancer risk (RR=1.11, 95% CI=0.67-1.86). CONCLUSIONS Our results indicate that high plasma 25(OH)D levels were significantly associated with improved survival in pancreatic cancer patients. However, there were no significant associations between vitamin D intake or plasma 25(OH)D levels and pancreatic cancer risk.
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Affiliation(s)
- Xi Zhang
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Xuan-Zhang Huang
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Wen-Jun Chen
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Jian Wu
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - You Chen
- Department of Pediatric Dentistry, The Wenzhou Dental Hospital, Lucheng, Wenzhou 325027, P.R. China
| | - Cong-Cong Wu
- Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng, Wenzhou 325027, P.R. China
| | - Zhen-Ning Wang
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Heping, Shenyang 110001, P.R. China
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Affiliation(s)
- R.A. Othman
- Department of Human Nutritional Sciences, The University of Manitoba and Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface General Hospital Research Centre, Winnipeg, Canada
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Barreto SG, Neale RE. Vitamin D and pancreatic cancer. Cancer Lett 2015; 368:1-6. [DOI: 10.1016/j.canlet.2015.06.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/04/2015] [Accepted: 06/25/2015] [Indexed: 12/17/2022]
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Davis-Yadley AH, Malafa MP. Vitamins in pancreatic cancer: a review of underlying mechanisms and future applications. Adv Nutr 2015; 6:774-802. [PMID: 26567201 PMCID: PMC4642423 DOI: 10.3945/an.115.009456] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although there is increasing evidence that vitamins influence pancreatic adenocarcinoma biology and carcinogenesis, a comprehensive review is lacking. In this study, we performed a PubMed literature search to review the anticancer mechanisms and the preclinical and clinical studies that support the development of the bioactive vitamins A, C, D, E, and K in pancreatic cancer intervention. Preclinical studies have shown promising results for vitamin A in pancreatic cancer prevention, with clinical trials showing intriguing responses in combination with immunotherapy. For vitamin C, preclinical studies have shown slower tumor growth rates and/or increased survival when used alone or in combination with gemcitabine, with clinical trials with this combination revealing decreased primary tumor sizes and improved performance status. Preclinical studies with vitamin D analogues have shown potent antiproliferative effects and repression of migration and invasion of pancreatic cancer cells, with a clinical trial showing increased time to progression when calciferol was added to docetaxel. For vitamin E, preclinical studies have shown that δ-tocotrienol and γ-tocotrienol inhibited tumor cell growth and survival and augmented gemcitabine activity. Early-phase clinical trials with δ-tocotrienol are ongoing. Vitamin K demonstrates activation of apoptosis and inhibition of cellular growth in pancreatic tumor cells; however, there are no clinical studies available for further evaluation. Although preclinical and clinical studies are encouraging, randomized controlled trials with endpoints based on insights gained from mechanistic and preclinical studies and early-phase clinical trials are required to determine the efficacy of bioactive vitamin interventions in pancreatic cancer.
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Affiliation(s)
- Ashley H Davis-Yadley
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL; and Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Mokenge P Malafa
- Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Piper MR, Freedman DM, Robien K, Kopp W, Rager H, Horst RL, Stolzenberg-Solomon RZ. Vitamin D-binding protein and pancreatic cancer: a nested case-control study. Am J Clin Nutr 2015; 101:1206-15. [PMID: 25904602 PMCID: PMC4441803 DOI: 10.3945/ajcn.114.096016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 03/16/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Vitamin D-binding protein (DBP) is the primary carrier of 25-hydroxyvitamin D [25(OH)D] in the circulation. One prospective study in male smokers found a protective association between DBP and pancreatic cancer, particularly among men with higher 25(OH)D concentrations. OBJECTIVE The objective was to examine the association between DBP and pancreatic cancer risk in an American population. DESIGN We conducted a nested case-control study in the Prostate, Lung, Colorectal, and Ovarian Cancer screening trial cohort of men and women aged 55-74 y at baseline. Between 1993 and 2010, 295 incident pancreatic adenocarcinoma cases were reported (follow-up to 15.1 y). Two controls (n = 590) were matched to each case by age, race, sex, and month of blood draw. We calculated smoking- and diabetes-adjusted ORs and 95% CIs with the use of conditional logistic regression. RESULTS DBP concentration was not significantly associated with pancreatic cancer overall [highest (≥7149.4 nmol/L) vs. lowest (<3670.4 nmol/L) quintile; OR: 1.75; 95% CI: 0.91, 3.37; P-trend = 0.25]. For serum 25(OH)D compared with the referent (50 to <75 nmol/L), individuals in the highest group had a significantly higher risk (≥100 nmol/L; OR: 3.23; 95% CI: 1.24, 8.44), whereas those in the lowest group had no significant association (<25 nmol/L; OR: 2.50; 95% CI: 0.92, 6.81). Further adjustment for DBP did not alter this association. CONCLUSION Our results do not support the hypothesis that serum DBP or 25(OH)D plays a protective role in pancreatic cancer. This trial was registered at clinicaltrials.gov as NCT00339495.
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Affiliation(s)
- Marina R Piper
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - D Michal Freedman
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Kim Robien
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - William Kopp
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Helen Rager
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Ronald L Horst
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH)
| | - Rachael Z Stolzenberg-Solomon
- From the Nutritional Epidemiology Branch (MRP and RZS-S) and the Radiation Epidemiology Branch (DMF), Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD; the Departments of Epidemiology and Biostatistics and Exercise Science, Milken Institute School of Public Health, George Washington University, Washington, DC (KR); the Clinical Support Laboratory, Leidos Biomedical Research Inc./Frederick National Laboratory for Cancer Research, Frederick, MD (WK and HR); and Heartland Assays Inc., Iowa State University, Ames, IA (RLH).
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Wang K, Dong M, Sheng W, Liu Q, Yu D, Dong Q, Li Q, Wang J. Expression of vitamin D receptor as a potential prognostic factor and therapeutic target in pancreatic cancer. Histopathology 2015; 67:386-97. [PMID: 25641222 DOI: 10.1111/his.12663] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/28/2015] [Indexed: 12/21/2022]
Abstract
AIMS Vitamin D insufficiency and deficiency are common among patients with pancreatic carcinoma, but epidemiological studies have shown inconsistent results for vitamin D intake/circulation level and pancreatic cancer risk. The study aims were to investigate the effects of vitamin D on patient survival, and the proliferation or survival of pancreatic cancer cell lines. METHODS AND RESULTS The present study examined the local expression of vitamin D receptor (VDR) in pancreatic normal and tumour tissues from a cohort of 61 patients, and analysed the potential correlation between VDR and pathological characteristics, including disease prognosis. Among 61 pairs of normal and tumour specimens, VDR was detected in all normal tissues, and was abundantly expressed in 62.5% (15/24) of tumour tissues with high differentiation, but had a significantly lower or undetectable expression level in 75.7% (28/37) of tissues with moderate or low differentiation (P = 0.004). Moreover, high VDR expression was detected in 63.6% (14/22) of small tumours (≤25 mm) and in only 25.6% (10/39) of large tumours (>25 mm) (P = 0.06). Kaplan-Meier analysis showed that a low level of VDR expression in tumour tissues was associated with a poor prognosis (P = 0.037). CONCLUSIONS VDR expression could be a potential prognostic factor for patients with pancreatic adenocarcinoma, and its effects should be examined in a prospective study. Vitamin D analogues may provide a therapeutic choice for patients with high VDR expression in tumours but a low vitamin D level in the circulation.
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Affiliation(s)
- Kewei Wang
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Ming Dong
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Weiwei Sheng
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Qingfeng Liu
- Department of General Surgery, People's Hospital of Liaoning Province, Shenyang, China
| | - Dongyang Yu
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Qi Dong
- Department of General Surgery, People's Hospital of Liaoning Province, Shenyang, China
| | - Qingchang Li
- Department of Pathology, The First Hospital of China Medical University, Shenyang, China
| | - Junqiang Wang
- Department of Pathology, The First Hospital of China Medical University, Shenyang, China
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Van Loon K, Owzar K, Jiang C, Kindler HL, Mulcahy MF, Niedzwiecki D, O'Reilly EM, Fuchs C, Innocenti F, Venook AP. 25-Hydroxyvitamin D levels and survival in advanced pancreatic cancer: findings from CALGB 80303 (Alliance). J Natl Cancer Inst 2014; 106:dju185. [PMID: 25099612 DOI: 10.1093/jnci/dju185] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Data from animal and cell-line models suggest that vitamin D metabolism plays an important role in pancreatic tumor behavior. Although vitamin D deficiency has been implicated in numerous cancers, the vitamin D status of patients with advanced pancreatic cancer and the effect of baseline vitamin D levels on survival are unknown. METHODS Participants in this correlative study (CALGB 151006) were enrolled in CALGB 80303, which was a randomized trial of patients with advanced pancreatic cancer that demonstrated no difference in overall survival (OS) among patients treated with gemcitabine plus placebo vs gemcitabine plus bevacizumab. We measured baseline serum 25-hydroxyvitamin D (25[OH]D) levels and examined associations between baseline 25(OH)D levels and progression-free survival and OS using the Cox rank score test. All statistical tests were two-sided. RESULTS Of 256 patients with available serum, the median 25(OH)D level was 21.7ng/mL (range 4 to 77). 44.5% of patients were vitamin D deficient (25[OH]D <20ng/mL), and 32.4% were insufficient (25[OH]D ≥20 and <30ng/mL). 25(OH)D levels were lower in black patients compared with white patients, and patients of other/undisclosed race (10.7 vs 22.4 vs 20.9ng/mL, P < .001). Baseline 25(OH)D levels were not associated with PFS (HR = 1.00, 95% CI = 0.99 to 1.01, P = .60) or OS (HR = 1.00, 95% CI = 0.99 to 1.01, P = .95). CONCLUSION Vitamin D deficiency was highly prevalent among patients with a new diagnosis of advanced pancreatic cancer. Black patients had statistically significantly lower 25(OH)D levels than white patients. In this cohort of patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy, baseline 25(OH)D levels were not associated with PFS or OS.
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Affiliation(s)
- Katherine Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Kouros Owzar
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Chen Jiang
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Hedy L Kindler
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Mary F Mulcahy
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Donna Niedzwiecki
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Eileen M O'Reilly
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Charles Fuchs
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Federico Innocenti
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
| | - Alan P Venook
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA (KVL, APV); Department of Biostatistics and Bioinformatics, Duke University, Durham, NC (KO, DN); Alliance Statistics and Data Center, Duke University, Durham, NC (KO, CJ, DN); The University of Chicago Medical Center, Chicago, IL (HLK); Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (MFM); Memorial Sloan-Kettering Cancer Center, New York, NY (EMO); Dana-Farber Cancer Institute, Boston, MA (CF); University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, School of Medicine, Lineberger Comprehensive Cancer Center, Chapel Hill, NC (FI)
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Vitamin E succinate inhibits survivin and induces apoptosis in pancreatic cancer cells. GENES AND NUTRITION 2011; 7:83-9. [PMID: 21842182 DOI: 10.1007/s12263-011-0242-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 07/21/2011] [Indexed: 12/20/2022]
Abstract
Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States. Identifying novel chemotherapeutic and chemopreventive approaches is critical in the prevention and treatment of cancers such as pancreatic cancer. Vitamin E succinate (VES) is a redox-silent analog of the fat-soluble vitamin alpha-tocopherol. In the present study, we explored the antiproliferative action of VES and its effects on inhibitor of apoptosis proteins in pancreatic cancer cells. We show that VES inhibits cell proliferation and induces apoptosis in pancreatic cancer cells. Further, we demonstrate that VES downregulates the expression of survivin and X-linked inhibitor of apoptosis proteins. The apoptosis induced by VES was augmented by siRNA-mediated inhibition of survivin in PANC-1 cells. In summary, our results suggest that VES targets survivin signaling and induces apoptosis in pancreatic cancer cells.
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Al-Wadei HAN, Ullah MF, Al-Wadei M. GABA (γ-aminobutyric acid), a non-protein amino acid counters the β-adrenergic cascade-activated oncogenic signaling in pancreatic cancer: a review of experimental evidence. Mol Nutr Food Res 2011; 55:1745-58. [PMID: 21805621 DOI: 10.1002/mnfr.201100229] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 12/11/2022]
Abstract
GABA is a bioactive constituent of fruits, vegetables, cereals and is believed to play a role in defense against stress in plants. In animals, it acts as an inhibitory neurotransmitter in brain while also expressed in non-neuronal cells. Studies have implicated the regulator of fight or flight stress responses, β-AR signaling cascade, as mediators of cancer growth and progression in in vitro and in vivo models of pancreatic malignancies. Pancreatic cancer is the fourth leading cause of cancer mortality in western countries. This malignancy is generally unresponsive to conventional radio- and chemotherapy, resulting in mortality rate near 100% within 6 months of diagnosis. We review a series of experiments from our laboratory and those of others examining the contribution of this signaling network to pancreatic and other human malignancies. Stimulation of the β-adrenergic receptor by lifestyle and environmental factors, as well as a pre-existing risk of neoplasm, activates downstream effector molecules that lead to pro-oncogenic signaling and thereby aid cancer growth. GABAergic signaling mediated by the serpentine receptor GABA(B) acts as an antagonist to β-adrenergic cascade by intercepting adenylyl cyclase. These evidences enhance the pharmacological value of human diets rich in GABA for use as an adjuvant to standard therapies.
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Affiliation(s)
- Hussein A N Al-Wadei
- Experimental Oncology Laboratory, Department of Pathobiology, University of Tennessee, Knoxville, TN 37996, USA.
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Analogs of vitamin E epitomized by alpha-tocopheryl succinate for pancreatic cancer treatment: in vitro results induce caution for in vivo applications. Pancreas 2010; 39:662-8. [PMID: 20562578 DOI: 10.1097/mpa.0b013e3181c8b48c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES alpha-Tocopheryl succinate (alpha-TOS) is thought to be toxic only for cancer cells. We ascertained in vitro alpha-TOS effects on pancreatic cancer (PC) and normal cell growth and verified whether the combination of nontoxic alpha-TOS and 5-fluorouracil (5-FU) doses causes cancer cell death and whether alpha-TOS effects are mediated by the proapoptotic proteins Bax/Bak and/or SMAD4/DPC4 status. METHODS Five PC cell lines, myoblasts, normal monocytes, wild-type (WT) and Bax/Bak double knockout mouse embryonic fibroblast (MEF) cells, and permanently SMAD4/DPC4-transfected PSN1 cells were cultured in 1% and 10% fetal calf serums (FCSs), without or with alpha-TOS (5-500 micromol/L). Nontoxic 5-FU (0.0001 mmol/L) and alpha-TOS alone or in combination were also evaluated. RESULTS Only PSN1 PC cell line, which had SMAD4/DPC4 homozygous deletion, was sensitive to nontoxic alpha-TOS doses (5 micromol/L in 1% FCS and 50 micromol/L in 10% FCS). A 20-micromol/L alpha-TOS inhibited MEF-WT, not MEF-double knockout growth. Only PSN1 cells were sensitive to nontoxic 5-FU and alpha-TOS combination. SMAD4/DPC4 transfection restored PSN1 resistance to the effects of combined 5-FU and alpha-TOS effects. CONCLUSIONS Only a minority of PC cells are sensitive to the antiproliferative effects of alpha-TOS, any sensitivity appearing to be correlated with SMAD4/DPC4 homozygous deletion and Bax/Bak expression.
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Abstract
Pancreatic cancer has a poor prognosis and is often diagnosed at an advanced stage, which makes it difficult to treat. The low survival rate of patients with pancreatic cancer points towards an increased need for novel therapeutic and chemopreventive strategies and also early detection of this disease. Increased consumption of fruits and vegetables has been associated with a reduced risk of pancreatic cancer. Synthetic and natural, diet-derived bioactive compounds have been evaluated as pancreatic cancer chemopreventive agents and have demonstrated various degrees of efficacy in cellular and in vivo animal models. Some chemopreventive agents (for example, curcumin or resveratrol) have also been reported to sensitize pancreatic cancer cells to standard chemotherapeutic drugs (for example, gemcitabine or erlotinib), which suggests that chemopreventive agents could potentially be used as potentiators of standard chemotherapy. Few clinical trials of pancreatic cancer chemopreventive agents have been completed and some are in early phases. Further development of pancreatic cancer chemopreventive agents may prove to be tremendously valuable for individuals at high risk of developing pancreatic cancer and patients who present with premalignant lesions. This Review discusses the current state of the pancreatic cancer chemoprevention field and highlights the challenges ahead.
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Stolzenberg-Solomon RZ, Hayes RB, Horst RL, Anderson KE, Hollis BW, Silverman DT. Serum vitamin D and risk of pancreatic cancer in the prostate, lung, colorectal, and ovarian screening trial. Cancer Res 2009; 69:1439-47. [PMID: 19208842 DOI: 10.1158/0008-5472.can-08-2694] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Experimental evidence suggests that vitamin D has anticarcinogenic properties; however, a nested case-control study conducted in a population of male Finnish smokers found that higher 25-hydroxyvitamin D [25(OH)D], the best indicator of vitamin D status as determined by the sun and diet, was associated with a significant 3-fold increased risk for pancreatic cancer. We conducted a nested case-control study in the Prostate, Lung, Colorectal, and Ovarian Screening Trial cohort of men and women 55 to 74 years of age at baseline to test whether prediagnostic serum 25(OH)D concentrations were associated with pancreatic cancer risk. Between 1994 and 2006, 184 incident cases of pancreatic adenocarcinoma occurred (follow-up to 11.7 years). Two controls (n = 368) who were alive at the time the case was diagnosed were selected for each case and matched by age, race, sex, and calendar date of blood draw (to control for seasonal variation). We calculated odds ratios (OR) and 95% confidence intervals (95% CI) using conditional logistic regression, adjusting for smoking and body mass index. Vitamin D concentrations were not associated with pancreatic cancer overall (highest versus lowest quintile, >82.3 versus <45.9 nmol/L: OR, 1.45; 95% CI, 0.66-3.15; P trend = 0.49). However, positive associations were observed among subjects with low estimated annual residential solar UBV exposure, but not among those with moderate to high annual exposure (P interaction = 0.015). We did not confirm the previous strong positive association between 25(OH)D and pancreatic cancer; however, the increased risk among participants with low residential UVB exposure is similar.
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Affiliation(s)
- Rachael Z Stolzenberg-Solomon
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland 20852, USA.
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Stolzenberg-Solomon RZ, Sheffler-Collins S, Weinstein S, Garabrant DH, Mannisto S, Taylor P, Virtamo J, Albanes D. Vitamin E intake, alpha-tocopherol status, and pancreatic cancer in a cohort of male smokers. Am J Clin Nutr 2009; 89:584-91. [PMID: 19116326 PMCID: PMC2647759 DOI: 10.3945/ajcn.2008.26423] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Evidence indicates that vitamin E has anticarcinogenic properties for gastrointestinal cancers; however, few studies have examined this with respect to exocrine pancreatic cancer. OBJECTIVE The objective was to examine whether vitamin E intake and serum alpha-tocopherol concentrations were prospectively associated with exocrine pancreatic cancer. DESIGN We conducted a cohort analysis of prediagnostic vitamin E intake (4 tocopherols, 4 tocotrienols), serum alpha-tocopherol concentrations, and pancreatic cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of male Finnish smokers aged 50-69 y at baseline. During follow-up from 1985 to 2004 (maximum: 19.4 y; median: 16 y), 318 incident cases were diagnosed among cohort participants with complete serum samples (n = 29,092); 306 cases had complete dietary data (n = 27,111). Cox proportional hazards models adjusted for age, smoking history, history of diabetes mellitus, and/or serum cholesterol were used to calculate hazard ratios (HRs) and 95% CIs. RESULTS Higher alpha-tocopherol concentrations were associated with lower pancreatic cancer risk (highest compared with lowest quintile, HR: 0.52; 95% CI: 0.34, 0.80; P for trend = 0.03; continuous HR: 0.91; 95% CI: 0.84, 0.99). Polyunsaturated fat, a putative prooxidant nutrient, modified the association such that the inverse alpha-tocopherol association was most pronounced in subjects with a high polyunsaturated fat intake (ie, >9.9 g/d; highest compared with lowest quintile, HR: 0.38; 95% CI: 0.20, 0.70; P for trend = 0.03; continuous HR: 0.86; 95% CI: 0.75, 0.97; P for interaction = 0.05 and 0.02, respectively). No associations were observed for dietary tocopherols and tocotrienols. CONCLUSION Our results support the hypothesis that higher alpha-tocopherol concentrations may play a protective role in pancreatic carcinogenesis in male smokers.
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Affiliation(s)
- Rachael Z Stolzenberg-Solomon
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department Health Human Services, Rockville, MD, USA.
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Stolzenberg-Solomon RZ. Vitamin D and pancreatic cancer. Ann Epidemiol 2008; 19:89-95. [PMID: 18504144 DOI: 10.1016/j.annepidem.2008.03.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Revised: 01/29/2008] [Accepted: 03/18/2008] [Indexed: 02/07/2023]
Abstract
Sun exposure has been associated with lower death rates for pancreatic cancer in ecological studies. Skin exposure to solar ultraviolet B radiation induces cutaneous production of precursors to 25-hydroxy (OH) vitamin D (D) and is considered the primary contributor to vitamin D status in most populations. Pancreatic islet and duct cells express 25-(OH) D(3)-1alpha-hydroxylase that generates the biologically active 1,25-dihydroxy(OH)(2) D form. Thus, 25(OH)D concentrations could affect pancreatic function and possibly pancreatic cancer etiology. Serum 25-(OH)D is the major circulating vitamin D metabolite and is considered the best indicator of vitamin D status as determined by the sun and diet. Although recent prospective epidemiologic studies of higher predicted vitamin D status score and vitamin D intake and pancreatic cancer risk suggest protective associations, a nested case-control study showed a significant 3-fold increased risk for pancreatic cancer with higher vitamin D status. Limitations of these studies include the former do not measure vitamin D status on pancreatic cancer cases and the later was conducted in a male smoker population. More research is needed, particularly examination of pre-diagnostic vitamin D status and risk of pancreatic cancer, prior to conclusions for vitamin D's potential role in the etiology of this highly fatal cancer.
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Affiliation(s)
- Rachael Z Stolzenberg-Solomon
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department Health Human Services, Rockville, MD, USA.
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Abstract
For many years, epidemiological studies continued to suggest that high fat diets are linked to an increased incidence of certain cancers. However, whether the oncogenic properties of fat are associated with their quantity rather than the quality has become debatable. Epidemiological studies have been suggesting that n-6 polyunsaturated fatty acids (n-6 PUFA) and saturated fats are more likely to increase the incidence of cancer, whereas monounsaturated fatty acids (MUFA) and n-3 polyunsaturated fatty acids (n-3 PUFA) are more likely to prevent or decrease the chance of carcinogenesis. A firm conclusion cannot be drawn yet because of insufficient research. This paper reviews the current knowledge of the effects of saturated fats, different types of unsaturated fats, and fat-soluble vitamins on the etiology of cancer.
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Affiliation(s)
- Ra Othman
- Department of Human Nutritional Sciences, The University of Manitoba and Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface General Hospital Research Centre, Winnipeg, Canada
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