Related Experiment Video
Updated: Aug 5, 2026
06:46
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
One-carbon metabolism and chemotherapy-induced toxicities in patients with stage II-III colorectal cancer: a
Nienke R K Zwart1, Fränzel J B van Duijnhoven1, Evertine Wesselink1
1Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
The American Journal of Clinical Nutrition
|July 27, 2026
Summary
This study found that higher levels of folate and vitamin B2 were linked to fewer capecitabine treatment modifications in colorectal cancer patients. Conversely, elevated glycine levels were associated with increased toxicity risk, suggesting potential for nutrition-guided therapy adjustments.
Area of Science:
- Oncology
- Nutritional Biochemistry
- Pharmacogenomics
Background:
- One-carbon metabolism (OCM) plays a role in capecitabine chemotherapy efficacy and toxicity.
- Investigating OCM biomarkers can help predict and manage capecitabine-induced toxicities in colorectal cancer (CRC).
Purpose of the Study:
- To examine the association between pretreatment OCM biomarker concentrations and capecitabine-induced toxicities in stage II-III CRC patients.
- To explore if MTHFR C677T genotype influences these associations.
Main Methods:
- Prospective cohort study of 297 CRC patients receiving adjuvant capecitabine chemotherapy.
- Measured plasma concentrations of folate, B2, B6, B12, homocysteine, methionine, serine, and glycine.
- Used Cox proportional hazards models and restricted cubic splines to analyze associations with toxicity-induced treatment modifications, adjusting for age and sex.
Main Results:
- Higher folate levels correlated with reduced toxicity risk in patients with MTHFR C677T CT/TT genotypes, but not CC genotype.
- Increased vitamin B2 concentrations were associated with a lower risk of toxicities.
- Elevated glycine levels were linked to a higher risk of toxicities.
- Non-linear associations were observed for vitamin B6 and B12; homocysteine, methionine, and serine showed no significant associations.
Conclusions:
- OCM biomarkers, particularly folate, vitamin B2, and glycine, show potential in predicting capecitabine treatment tolerance.
- Further research is needed to determine if optimizing OCM biomarkers through nutritional interventions can improve treatment outcomes.
Related Concept Videos
02:49Cancer Therapies
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
01:46Electron Transport Chain: Complex I and II
The mitochondrial electron transport chain (ETC) is the main energy generation system in the eukaryotic cells. However, mitochondria also produce cytotoxic reactive oxygen species (ROS) due to the large electron flow during oxidative phosphorylation. While Complex I is one of the primary sources of superoxide radicals, ROS production by Complex II is uncommon and may only be observed in cancer cells with mutated complexes.
ROS generation is regulated and maintained at moderate levels necessary...
ROS generation is regulated and maintained at moderate levels necessary...
01:11Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase
Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
02:57Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
02:50Combination Therapies and Personalized Medicine
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
01:25Mutagenicity and Carcinogenicity
Mutagenicity and carcinogenicity refer to the ability of drugs to cause genetic defects and induce cancer, respectively. The International Agency for Research on Cancer (IARC) classifies agents into four groups based on their carcinogenic potential. Group 1 agents are known human carcinogens; group 2A agents are probably carcinogenic to humans; group 3 agents lack data to support their role in carcinogenesis; and group 4 includes agents for which data support that they are not likely to be...