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Abstract Title:

A Pilot Study of Silymarin as Supplementation to Reduce Toxicities in Metastatic Colorectal Cancer Patients Treated With First-Line FOLFIRI Plus Bevacizumab.

Abstract Source:

Oncol Res. 2021 Sep 7 ;28(7):801-809. Epub 2021 May 24. PMID: 34030768

Abstract Author(s):

Tsung-Kun Chang, Tzu-Chieh Yin, Wei-Chih Su, Hsiang-Lin Tsai, Ching-Wen Huang, Yen-Cheng Chen, Ching-Chun Li, Po-Jung Chen, Cheng-Jen Ma, Kuo-Hsiang Chuang, Tian-Lu Cheng, Jaw-Yuan Wang

Article Affiliation:

Tsung-Kun Chang

Abstract:

Irinotecan, a topoisomerase inhibitor, is a common cytotoxic agent prescribed for metastatic colorectal cancer (mCRC) patients. Diarrhea is the most common adverse event (AE). The underlying mechanism of irinotecan-induced diarrhea is intestinal mucosal damage caused by SN-38 (active metabolite of irinotecan) hydrolyzed from SN-38G (inactive metabolite) by bacterial -glucuronidase (G). According to an animal study, silymarin reduces the activity of bacterial G without impairing antitumor efficacy. We conducted a prospective open-label pilot study to evaluate the effect of silymarin as supplementation in reducing toxicities of mCRC patients undergoing irinotecan-based chemotherapy. We enrolled and randomized 70 mCRC patients receiving first-line FOLFIRI (5-fluorouracil/leucovorin/irinotecan) plus bevacizumab. In each treatment cycle, the study group was administered silymarin capsules (150 mg) three times daily for 7 days. The study group experienced less AEs in diarrhea (5.7% vs. 14.6%,=0.002) and nausea (27.0% vs. 40.2%,=0.005) in comparison with the control group, but no significant differences in hepatic toxicities were observed. In conclusion, simultaneous administration of silymarin is a potential effective supplementation for reducing toxicities in mCRC patients undergoing first-line FOLFIRI plus bevacizumab, especially in diarrhea and nausea.

Study Type : Human Study

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