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Prevention of chemotherapy and radiation toxicity with glutamine.
Cancer Treat Rev 2003; 29(6):501-13CT

Abstract

GOALS OF THE WORK

Malignancy produces a state of physiologic stress that is characterized by a relative deficiency of glutamine, a condition that is further exacerbated by the effects of cancer treatment. Glutamine deficiency may impact on normal tissue tolerance to antitumor treatment, and may lead to dose reductions and compromised treatment outcome. Providing supplemental glutamine during cancer treatment has the potential to abrogate treatment-related toxicity. We reviewed the available data on the use of glutamine to decrease the incidence and severity of adverse effects due to chemotherapy and/or radiation in cancer patients.

METHODS

We performed a search of the MEDLINE database during the time period 1980-2003, and reviewed the English language literature of both human and animal studies pertaining to the use of glutamine in subjects with cancer. We also manually searched the bibliographies of published articles for relevant references.

MAIN RESULTS

The available evidence suggests that glutamine supplementation may decrease the incidence and/or severity of chemotherapy-associated mucositis, irinotecan-associated diarrhea, paclitaxel-induced neuropathy, hepatic veno-occlusive disease in the setting of high dose chemotherapy and stem cell transplantation, and the cardiotoxicity that accompanies anthracycline use. Oral glutamine supplementation may enhance the therapeutic index by protecting normal tissues from, and sensitizing tumor cells to chemotherapy and radiation-related injury.

CONCLUSIONS

The role of glutamine in the prevention of chemotherapy and radiation-induced toxicity is evolving. Glutamine supplementation is inexpensive and it may reduce the incidence of gastrointestinal, neurologic, and possibly cardiac complications of cancer therapy. Further studies, particularly placebo-controlled phase III trials, are needed to define its role in chemotherapy-induced toxicity.

Authors+Show Affiliations

Division of Hematology Oncology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA. dsavarese@uptodate.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

14585260

Citation

Savarese, Diane M F., et al. "Prevention of Chemotherapy and Radiation Toxicity With Glutamine." Cancer Treatment Reviews, vol. 29, no. 6, 2003, pp. 501-13.
Savarese DM, Savy G, Vahdat L, et al. Prevention of chemotherapy and radiation toxicity with glutamine. Cancer Treat Rev. 2003;29(6):501-13.
Savarese, D. M., Savy, G., Vahdat, L., Wischmeyer, P. E., & Corey, B. (2003). Prevention of chemotherapy and radiation toxicity with glutamine. Cancer Treatment Reviews, 29(6), pp. 501-13.
Savarese DM, et al. Prevention of Chemotherapy and Radiation Toxicity With Glutamine. Cancer Treat Rev. 2003;29(6):501-13. PubMed PMID: 14585260.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of chemotherapy and radiation toxicity with glutamine. AU - Savarese,Diane M F, AU - Savy,Gayle, AU - Vahdat,Linda, AU - Wischmeyer,Paul E, AU - Corey,Barbara, PY - 2003/10/31/pubmed PY - 2003/12/3/medline PY - 2003/10/31/entrez SP - 501 EP - 13 JF - Cancer treatment reviews JO - Cancer Treat. Rev. VL - 29 IS - 6 N2 - GOALS OF THE WORK: Malignancy produces a state of physiologic stress that is characterized by a relative deficiency of glutamine, a condition that is further exacerbated by the effects of cancer treatment. Glutamine deficiency may impact on normal tissue tolerance to antitumor treatment, and may lead to dose reductions and compromised treatment outcome. Providing supplemental glutamine during cancer treatment has the potential to abrogate treatment-related toxicity. We reviewed the available data on the use of glutamine to decrease the incidence and severity of adverse effects due to chemotherapy and/or radiation in cancer patients. METHODS: We performed a search of the MEDLINE database during the time period 1980-2003, and reviewed the English language literature of both human and animal studies pertaining to the use of glutamine in subjects with cancer. We also manually searched the bibliographies of published articles for relevant references. MAIN RESULTS: The available evidence suggests that glutamine supplementation may decrease the incidence and/or severity of chemotherapy-associated mucositis, irinotecan-associated diarrhea, paclitaxel-induced neuropathy, hepatic veno-occlusive disease in the setting of high dose chemotherapy and stem cell transplantation, and the cardiotoxicity that accompanies anthracycline use. Oral glutamine supplementation may enhance the therapeutic index by protecting normal tissues from, and sensitizing tumor cells to chemotherapy and radiation-related injury. CONCLUSIONS: The role of glutamine in the prevention of chemotherapy and radiation-induced toxicity is evolving. Glutamine supplementation is inexpensive and it may reduce the incidence of gastrointestinal, neurologic, and possibly cardiac complications of cancer therapy. Further studies, particularly placebo-controlled phase III trials, are needed to define its role in chemotherapy-induced toxicity. SN - 0305-7372 UR - https://www.unboundmedicine.com/medline/citation/14585260/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0305737203001336 DB - PRIME DP - Unbound Medicine ER -