Melatonin and Irinotecan

[beach sunrise]

I am going to post as many of these studies as possible before subscription is up.


Melatonin and Irinotecan
A clinical study, in the journal Anticancer Research, supported the use of the antioxidant hormone melatonin along with chemotherapy. Scientists randomized patients to receive the standard but toxic drug irinotecan (CPT-11) alone vs. irinotecan with melatonin in metastatic colorectal cancer patients whose cancer had already progressed on 5-fluorouracil-containing chemotherapy combinations.

“Recent advances in immunobiological knowledge,” the investigators wrote, “have suggested the possibility of enhancing the therapeutic activity of various chemotherapeutic agents by a concomitant administration of anti-oxidant drugs and/or immunomodulating neurohormones” (for example, melatonin).
(Cerea G, Vaghi M, Ardizzoia A, et al. Biomodulation of cancer chemotherapy for metastatic colorectal cancer: a randomized study of weekly low-dose irinotecan alone versus irinotecan plus the oncostatic pineal hormone melatonin in metastatic colorectal cancer patients progressing on 5-fluorouracil-containing combinations. Anticancer Res. 2003 Mar-Apr;23(2C):1951-4)
Melatonin acts as both an antioxidant and an immune modulator. This study evaluated the effect of administering melatonin alongside CPT-11, also called irinotecan and Camptosar®. This is a drug widely used as part of FOLFIRI, a common second-line treatment for metastatic colorectal cancer. Melatonin was given to such patients orally at 20 milligrams per day during the evening (when melatonin is most effective).

A partial response (PR) was achieved in 2 out of 16 patients (12.5%) treated with CPT-11 alone but in 5 out of 14 patients (35.7%) who were treated concomitantly with melatonin. Stable disease was obtained in 5 out of 16 patients (31.3%) treated with CPT-11 alone and in 7 out of 14 patients (50.0%) treated with CPT-11 plus melatonin. The degree of improvement was statistically significant. The authors concluded that the effectiveness of CPT-11 may be enhanced by a daily administration of melatonin. This accords with results that were previously reported for the combined use of melatonin and other chemotherapeutic agents.

If antioxidants truly interfered with chemotherapy, as many oncologists maintain, then one would expect to see this interference showing up in clinical trials, such as those discussed above. In truth, this doctrine of interference has always been based more on fear than on fact. A growing body of clinical as well as laboratory data supports the concurrent use of these two important modalities. An added bonus is that antioxidants such as vitamin E and melatonin are readily available for pennies per day. They promise a lot of benefits for a small price, a major consideration when treating people with limited economic resources. (The cost of 20 mg of melatonin is generally under ten cents.)

For years, oncologists have demanded proof, in the form of randomized controlled trials (RCTs), that antioxidants do not interfere with chemotherapy. But when the proof came it made no impression on the mass of oncologists. Nothing quelled their fear or led to a more sympathetic assessment of antioxidants’ role in cancer treatment.

Yet if someone had shown that vitamin E interfered with cisplatin it would have generated scare headlines all over the world. The bad news about the alleged danger of supplements is good for newspaper circulation or clicks. Favorable news, including a two-thirds reduction in serious side effects of chemotherapy, is not.

Meanwhile, the subject of vitamin C and its effect on the immune system continues to fascinate researchers and laypeople alike. A study carried out by a research team from the Harvard School of Public Health, Boston, and published in the New England Journal of Medicine showed that a multivitamin supplement that included vitamin C significantly slowed the onset of HIV/AIDS thereby providing an “effective, low-cost means of delaying the initiation of antiretroviral therapy in HIV-infected women.”

(Fawzi WW, et al. A randomized trial of multivitamin supplements and HIV disease progression and mortality N Engl J Med 2004;351:23-32)
The total cost of the treatment was estimated by the researchers to be about $15 per year. Here is yet another demonstration of the astonishing potential of food supplements, particularly antioxidants such as vitamin C, to promote human health. And, once more, the American medical system (under the sway of the pharmaceutical industry) chooses the most expensive (and therefore profitable) solution, instead of the cheap, natural one.