Abstract
Background: Ascorbate (vitamin C) has been evaluated as a potential treatment for cancer as an independent agent and in combination with standard chemotherapies. This review assesses the evidence for safety and clinical effectiveness of intravenous (IV) ascorbate in treating various types of cancer. Methods: Single arm and randomized Phase I/II trials were included in this review. The PubMed, MEDLINE, and Cochrane databases were searched. Results were screened by three of the authors (GN, RP, and CJP) to determine if they met inclusion criteria, and then summarized using a narrative approach. Results: A total of 23 trials involving 385 patients met the inclusion criteria. Only one trial, in ovarian cancer, randomized patients to receive vitamin C or standard of care (chemotherapy). That trial reported an 8.75 month increase in progression-free survival (PFS) and an improved trend in overall survival (OS) in the vitamin C treated arm. Conclusion: Overall, vitamin C has been shown to be safe in nearly all patient populations, alone and in combination with chemotherapies. The promising results support the need for randomized placebo-controlled trials such as the ongoing placebo-controlled trials of vitamin C and chemotherapy in prostate cancer.
Highlights
Ascorbate was proposed to have anticancer effects as early as the 1950s [1,2] the earliest effort to using high-dose vitamin C—both intravenously (IV) and orally—as a cancer treatment occurred in the 1970s, by Scottish surgeon Ewan Cameron and his colleague Allan Campbell.For comparison purposes, in 1974, the recommended dietary allowance of vitamin C was 0.045 g (45 mg) daily [3]
Out of the 23 clinical trials included in this paper, 11 trials with a total of 200 patients used low dose intravenous ascorbic acid in combination with arsenic trioxide (As2 O3 ) (Table 1)
The results suggest that IV ascorbate could induce reduction in toxicities, perhaps via mechanisms that are different than those that target cancer cells
Summary
Ascorbate (vitamin C) was proposed to have anticancer effects as early as the 1950s [1,2] the earliest effort to using high-dose vitamin C—both intravenously (IV) and orally—as a cancer treatment occurred in the 1970s, by Scottish surgeon Ewan Cameron and his colleague Allan Campbell.For comparison purposes, in 1974, the recommended dietary allowance of vitamin C was 0.045 g (45 mg) daily [3]. Cameron and Campbell treated 50 patients with various types of advanced cancers with high doses of oral ascorbate, IV ascorbate, or both. The data obtained from these cancer patients suggested that there was a potential survival benefit when their treatment was supplemented with oral and IV vitamin C [7,8]. Limitations of these findings have subsequently been described [9], including that the findings were retrospective, without controls or blinding, and that studied patients may have been at risk for endemic vitamin C deficiency. In ovarian cancer, randomized patients to receive vitamin C or standard of care (chemotherapy). That trial reported an 8.75 month increase in progression-free survival (PFS)
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