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Vitamin A boosts Pancreatic Cancer Chemotherapy

2016-05-30
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    During World War II, the British government began a disinformation campaign that the Royal Air Force pilots were fed high-carrot diets, giving them superior night vision and the ability to spot the enemy in the dark. In reality, the Allies were doing their best to keep their brand-new RADAR technology under wraps. How well the ruse worked on the German forces needs to be clarified. Still, the myth has been propagated over the years to the point where scientists even tried to lend the tale some credence by suggesting that carrots' high vitamin A levels were giving the pilots their supervision. This part of the myth is rooted in natural science, as evidenced by the fact that nyctalopia—or night blindness—can develop through vitamin A deficiency.

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    The addition of high doses of vitamin A could help make chemotherapy more successful in treating pancreatic cancer, according to an early study by Queen Mary University of London (QMUL). The promising initial results have led to the potential treatment being tested in a new clinical trial. The researchers found that combining a chemical form of vitamin A with chemotherapeutic compounds increased the successful treatment of pancreatic cancer.

      Pancreatic tumors typically comprise aggressive cancer cells that often tend to be intractable to treatment with chemo- and radiotherapy alone. Moreover, while surgery to remove the tumor offers the best chance of survival, most patients are diagnosed when cancer has already spread to other organs. A different approach is therefore needed to target the tumor more effectively.

      "Pancreatic cancer is tough to treat by chemotherapy, so this finding is important because vitamin A targets the noncancerous tissue and makes the existing chemotherapy more effective, killing the cancer cells and shrinking tumors," explained senior study author Professor Hemant Kocher, M.D., professor of liver and pancreas surgery at QMUL's Barts Cancer Institute. "This could potentially apply to other cancers because if we try to understand cancer as a whole, including its surrounding tissue, we may be able to develop new and better treatments."

      Cancer cells are typically surrounded by other tissue comprised of stromal cells, which can make up 80% of the pancreatic cancer mass. These relatively normal tissue cells communicate with the cancer cells and play a significant role in the progression of the disease—offering a possible new target for treatment.

      In this new study, in vitro cultures and mice were tested using a new approach of simultaneously targeting stromal cells and cancer cells. By using gemcitabine chemotherapy to target cancer cells and a form of vitamin A to target the surrounding stromal cells, the combined approach led to a reduction in cancer cell proliferation and invasion.

      "This is the first time we have combined vitamin A with chemotherapy for pancreatic cancer," Dr. Kocher noted. "The results are so promising that we're now taking this into a clinical trial."

      The findings from this study were published recently in the Journal of Pathology in an article entitled "Anti-Stromal Treatment Together with Chemotherapy Targets Multiple Signalling Pathways in Pancreatic Adenocarcinoma."

      It targets stromal cells and cancer cells and blocks multiple cell signaling pathways used by cancer cells to become aggressive. This means that the cancer cells can no longer communicate as effectively, and the tumor does not grow as it otherwise would.

      The new approach is being tested in a clinical trial led by Barts Cancer Institute's Centre for Experimental Cancer Medicine. The problem hopes to establish a safe combination of two chemotherapy medications with a stromal targeting agent and is currently recruiting participants.

      "The majority of experimental work was done as part of my Ph.D. project, and I am excited that our hard work in the laboratory is now being tested in the form of a clinical trial," remarked lead study author Elisabete Carapuça, a graduate student at QMUL. "We hope that it will benefit patients facing this awful disease."

    The QUML team now looks forward to the newly initiated clinical trial results. However, they caution patients that consuming vitamin A supplements is not recommended at this stage because the results are not proven in human clinical trials.


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