Liver lectin blocking with D-galactose to prevent hepatic metastases in colorectal carcinoma patients
Related Experiment Videos
J Isenberg1, B Stoffel, H Stützer
1Clinics and Policlinics for Surgery, University Cologne, Germany.
Abstract:
Animal experiments in BALB/c-mice and in DBA/2-mice confirmed that lectin blockade with D-galactose containing receptor analogues can inhibit metastatic spread into the liver. The number of liver colonies of inoculated tumor cells was significantly reduced after D-galactose treatment as compared to animals of control group. Based on experimental investigations 193 colorectal carcinoma patients (UICC stages I-III) were enrolled in a prospectively randomized clinical trial. 93 patients were treated perioperatively with D-galactose- (treatment group: 1.5 g/kg body weight and per day) or D-glucose containing electrolyte infusions (control group: n = 100). Significant side effects were not observed. There were no cases of perioperative mortality. The overall complication rate was 7.3%. Since tumor stages were unequally distributed, analysis was performed in strata. Patients were observed for a total of 6237 months. Differences in overall survival and survival free of recurrence and hepatic metastases were negligible for stages I and II. For stage III carcinoma patients (n = 75) analysis of survival free of hepatic metastases revealed a shift to delayed events (i.e. hepatic metastases or death) after D-galactose treatment within 24 months following surgery. In patients with stage III carcinoma there was an indication for an overall benefit in survival after D-galactose treatment (p = 0.102).
Insights
D-galactose lectin blockade shows promise in inhibiting liver metastasis for colorectal cancer patients. While early stages saw no significant difference, stage III patients exhibited delayed hepatic metastases and a trend towards improved survival after D-galactose treatment.
Area of Science:
- Oncology
- Biochemistry
- Clinical Medicine
Background:
- Metastatic spread to the liver is a significant challenge in colorectal carcinoma.
- Lectin-mediated adhesion plays a role in tumor cell metastasis.
- D-galactose is a carbohydrate that can block specific lectin interactions.
Purpose of the Study:
- To investigate the efficacy of D-galactose lectin blockade in preventing liver metastasis.
- To evaluate the safety and survival outcomes of perioperative D-galactose treatment in colorectal cancer patients.
Main Methods:
- Animal experiments in mice (BALB/c and DBA/2) were conducted to assess metastatic inhibition.
- A prospectively randomized clinical trial involving 193 colorectal carcinoma patients (UICC stages I-III) was performed.
- Patients received perioperative electrolyte infusions containing either D-galactose (1.5 g/kg/day) or D-glucose (control).
Main Results:
- D-galactose treatment significantly reduced liver colonies in animal models.
- No significant differences in overall survival or recurrence-free survival were observed for stages I and II colorectal cancer patients.
- For stage III patients, D-galactose treatment showed a trend towards delayed hepatic metastases and improved overall survival (p=0.102) within 24 months post-surgery.
Conclusions:
- D-galactose lectin blockade demonstrates potential in reducing liver metastasis.
- Perioperative D-galactose treatment appears safe with low complication rates.
- Further investigation is warranted for stage III colorectal cancer patients to confirm survival benefits.