Assessment of 8-isoprostane (8-isoPGF_2α) in Urine of Non-Small Cell Lung Cancer (NSCLC) Patients Undergoing Chemotherapy

Abstract

Abstract8-isoprostane (8-isoPGF 2α ) is a reliable marker and considered a gold standard for lipid peroxidation. There are very few reports of 8-isoprostane levels in cancer patients, and in patients undergoing chemotherapy. Oxidative stress is however expected and has been observed in patients with cancer. This study measured 8-isoprostane levels in urine by ELISA of 25 patients undergoing chemotherapy for advanced non-small cell lung cancer, at cycles 1, 2, and 3 of treatment. It considers the creatinine clearance of the patients, and correction of 8-isoprostane levels by creatinine clearance, and overnight urine volume methods. The average 8-isoprostane levels in urine increased more than 6 to 12 fold on chemotherapy treatment, from 532 ±587 pg/mL at cycle 1, 6181 ± 4334 at cycle 2, and 5511 ± 2055 at cycle 3. Similar results were obtained if 8-isoprostane levels were corrected for overnight urine volume, giving averages of 285 ± 244 µg at cycle 1, 4122 ± 3349 at cycle 2, and 3266 ± 1200 at cycle 3. No significant difference was seen in average total overnight urine volume or number of urinations between chemotherapy cycles except for a large variation in urine volume between cycle 2 and 3. Creatinine levels were significantly different only between cycles 1 and 2 (p=0.016). In conclusion, cisplatin therapy has been shown to induce high levels of lipid peroxidation in lung cancer patients and can be assessed from the 8-isoprostane marker in overnight urine, with or without urine volume correction.

Effect of Zinc Supplementation on Antioxidant Defenses and Oxidative Stress Markers in Patients Undergoing Chemotherapy for Colorectal Cancer: a Placebo-Controlled, Prospective Randomized Trial

“…Patients undergoing chemotherapy for advanced non-small cell lung cancer showed increased (over 6-to 12-fold from baseline) 8-isoprostane concentration in urine during chemotherapy with cisplatin, an extremely cytotoxic drug [6]. However, immediately after chemotherapy for breast cancer, 8-isoprostane concentration is similar to that in healthy individuals [39].…”

“…The antioxidant capacity is likely to be greater among individuals with low oxidative status prior to the chemotherapy and the contribution of ROS downregulation greater among those with higher oxidative status [43], suggesting the existence of different redox phenotypes. Further studies could establish whether the effect of zinc supplementation depends on phenotypic responses to oxidative stress and whether the supplementation can reduce the cellular damage without diminishing the effectiveness of the antineoplastic drugs [6].…”

“…In addition, non-enzymatic antioxidants, e.g., ascorbic acid, α-tocopherol, and β-carotene as well as zinc, copper, and manganese, have an indirect antioxidant activity [5]. The imbalance between the anti-and pro-oxidant systems may result in increased production of lipid peroxidation compounds [3], including malondialdehyde (MDA) [5] and 8-isoprostane [6,7].…”

Pu-erh Tea Powder Preventive Effects on Cisplatin-Induced Liver Oxidative Damage in Wistar Rats

“…CDDP causes the generation of ROS, depletion of GSH, and inhibition of antioxidant enzymes activity. Johns et al (2012) concluded that cisplatin therapy had been shown to induce high levels of lipid peroxidation in lung cancer patients and could be assessed from the 8-isoprostane marker in overnight urine, with or without volume correction (Johns et al, 2012). Thus, the administration of antioxidants such as vitamin C, vitamin E, Silymarin, selenium, and so on before the administration of CDDP has been used to protect against kidney and liver toxicities (Ajith et al, 2009;Abdelmeguid et al, 2010;Ghorbani et al, 2013).…”

Impact of chemotherapy on symptom profile, oxidant-antioxidant balance and nutritional status in non-small cell Lung Cancer

“…[6] The administration of chemotherapy is also associated with increased free radicals and decreased antioxidants. [78] This oxidant-antioxidant imbalance plays a role in the side effects of chemotherapy drugs as well,[9] for example, cisplatin-induced nephrotoxicity. [10]…”