INSERM U921 Nutrition, Croissance et Cancer, Tours, France.
Br J Cancer. 2009 Dec 15;101(12):1978-85. doi: 10.1038/sj.bjc.6605441. Epub 2009 Nov 17.
Breast cancer becomes lethal when visceral metastases develop. At this stage, anti-cancer treatments aim at relieving symptoms and delaying death without resulting in additional toxicity. On the basis of their differential anti-oxidant defence level, tumour cells can be made more sensitive to chemotherapy than non-tumour cells when membrane lipids are enriched with docosahexaenoic acid (DHA), a peroxidisable and oxidative-stress-inducing lipid of marine origin.
This open-label single-arm phase II study evaluated the safety and efficacy (response rate), as primary end points, of the addition of 1.8 g DHA daily to an anthracycline-based chemotherapy (FEC) regimen in breast cancer patients (n = 25) with rapidly progressing visceral metastases. The secondary end points were time to progression (TTP) and overall survival (OS).
The objective response rate was 44%. With a mean follow-up time of 31 months (range 2-96 months), the median TTP was 6 months. Median OS was 22 months and reached 34 months in the sub-population of patients (n = 12) with the highest plasma DHA incorporation. The most common grade 3 or 4 toxicity was neutropaenia (80%).
DHA during chemotherapy was devoid of adverse side effects and can improve the outcome of chemotherapy when highly incorporated. DHA has a potential to specifically chemosensitise tumours.
当内脏转移发展时，乳腺癌变得致命。在这个阶段，抗癌治疗旨在缓解症状和延缓死亡，而不会产生额外的毒性。基于其不同的抗氧化防御水平，当细胞膜脂质富含二十二碳六烯酸 (DHA) 时，肿瘤细胞可以比非肿瘤细胞对化疗更敏感，DHA 是一种源自海洋的可过氧化和诱导氧化应激的脂质。
这项开放标签的单臂 II 期研究评估了在乳腺癌患者（n = 25）中添加每天 1.8 g DHA 对基于蒽环类药物的化疗（FEC）方案的安全性和疗效（反应率）作为主要终点，快速进展的内脏转移。次要终点是无进展生存期 (TTP) 和总生存期 (OS)。
客观缓解率为 44%。中位随访时间为 31 个月（范围 2-96 个月），中位 TTP 为 6 个月。中位 OS 为 22 个月，在最高血浆 DHA 结合的患者亚群（n = 12）中达到 34 个月。最常见的 3 级或 4 级毒性是中性粒细胞减少症（80%）。
化疗期间的 DHA 没有不良副作用，并且当高度结合时可以改善化疗的结果。DHA 有可能特异性地使肿瘤对化疗敏感。
