Pharmacological dose ascorbic acid administration in relapsed refractory multiple myeloma patients

Abstract

Objective High-dose ascorbic acid leads to the formation of highly reactive oxygen species due to the pro-oxidant effect, resulting in cell death; therefore, used as an additive treatment in several malignancies. We present the results obtained by administration of pharmacological dose of ascorbic acid to conventional chemotherapy in relapsed refractory multiple myeloma patients. Materials-methods Intravenous ascorbic acid at a pharmacologic dose of 15 gram/week was added to the chemotherapy regimen of relapsed refractory multiple myeloma patients, who received carfilzomib-lenalidomide-dexamethasone treatment and did not respond after the second cycle. Results The total of 4 patients who had previously received 6–9 lines of myeloma treatment were included. After 4 cycles of chemotherapy + ascorbic acid combination, 1 patient had a complete response whereas other patients had a very good partial response. Conclusion The addition of pharmacological dose ascorbic acid to conventional chemotherapy can be an effective approach in relapsed refractory patients. Clinical studies with a large number of patients will be useful to evaluate the pharmacological dose of ascorbate in plasma cell disorders.

Ascorbic acid in cancer management – time for a second look

“…However, in a clinical study reported by Bolaman et al, AA enhanced the cytotoxic effect of carfilzomib-lenalidomide-dexamethasone in relapsed/ refractory myeloma patients who initially did not respond to the treatment; thus AA may have no effect on carfilzomib at pharmacological dose. [193][194][195][196][197][198][199] In a phase I-II clinical trial (NCT01050621), Hoffer et al recommended carrying out trials in higher numbers in order to identify specific clusters of cancer type, chemotherapy regimen and AA combination in which exceptional responses are observed to justify a more focused clinical trial. 196 This position is appropriate.…”