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A number of studies have included IV ascorbic acid treatment at a fixed dose of 1, mg with arsenic trioxide regimens, with mixed results. Use our advanced clinical trial search to find NCI-supported cancer clinical trials that are now enrolling patients.

The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. General information about clinical trials is also available.

Intravenous IV high- dose ascorbic acid has been generally well tolerated in clinical trials. Case reports have indicated that patients with glucosephosphate dehydrogenase GPD deficiency should not receive high doses of vitamin C because of the risk of developing hemolysis.

Vitamin C may increase bioavailability of iron , and high doses of the vitamin are not recommended for patients with hemochromatosis.

When administered in high doses, vitamin C may result in adverse interactions with some anticancer agents. These interactions have primarily been detected in preclinical studies.

A phase I clinical study evaluated the safety of combining high-dose IV ascorbate with gemcitabine in stage IV pancreatic cancer patients.

The combination therapy was well tolerated by patients, and no significant adverse events were reported.

Another study found similar results. Plasma from healthy volunteers who took 1 g of oral vitamin C per day was shown to decrease bortezomib growth inhibition in multiple myeloma cells and to block its inhibitory effect on 20S proteasome activity.

Several studies have been performed to assess the potential synergistic or inhibitory action of vitamin C on certain chemotherapy drugs , with variable results.

A series of studies in cell culture and in animals bearing tumors has shown that when given at high concentrations or dosages, dehydroascorbic acid an oxidized form of vitamin C can interfere with the cytotoxic effects of several chemotherapy drugs.

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Added text to state that another in vitro study found that ascorbic acid killed colorectal cancer cells with KRAS or BRAF mutations by inhibiting the enzyme glyceraldehyde 3-phosphate dehydrogenase cited Yun et al.

This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of high-dose vitamin C in the treatment of people with cancer.

It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.

Board members review recently published articles each month to determine whether an article should:. Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.

Any comments or questions about the summary content should be submitted to Cancer. Do not contact the individual Board Members with questions or comments about the summaries.

Board members will not respond to individual inquiries. Some of the reference citations in this summary are accompanied by a level-of-evidence designation.

These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches.

PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated.

Permission to use images outside the context of PDQ information must be obtained from the owner s and cannot be granted by the National Cancer Institute.

Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online , a collection of over 2, scientific images.

The information in these summaries should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.

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Questions to Ask About Cancer. Choices for Care. Talking about Your Advanced Cancer. Planning for Advanced Cancer. Advanced Cancer and Caregivers. Questions to Ask about Advanced Cancer.

Managing Cancer Care. Finding Health Care Services. Advance Directives. Using Trusted Resources. Coronavirus Information for Patients. Clinical Trials during Coronavirus.

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NCI Grant Policies. Legal Requirements. Step 3: Peer Review and Funding Outcomes. Manage Your Award.

Grants Management Contacts. Prior Approvals. Annual Reporting and Auditing. Transfer of a Grant.

Grant Closeout. Cancer Training at NCI. Resources for Trainees. Funding for Cancer Training. Building a Diverse Workforce. Resources for News Media.

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Immune System Modulators. Targeted Therapy. Stem Cell Transplant. Precision Medicine. Steps to Find a Clinical Trial.

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Use of Placebos. Research Team Members. Paying for Clinical Trials. Insurance Coverage and Clinical Trials. Federal Government Programs.

Patient Safety. Informed Consent. Children's Assent. Scientific Review. Ending Trials Early. Deciding to Take Part in a Trial. Questions to Ask about Treatment Clinical Trials.

Drugs Approved for Different Types of Cancer. Drugs Approved for Childhood Cancers. Drugs Approved for Conditions Related to Cancer.

Access to Experimental Drugs. Vitamin C is an essential nutrient with redox functions at normal physiologic concentrations.

Laboratory studies have reported that high-dose vitamin C has redox properties and decreased cell proliferation in prostate , pancreatic , hepatocellular , colon , mesothelioma , and neuroblastoma cell lines.

Studies of vitamin C combined with other drugs in animal models have shown mixed results. Intravenous vitamin C has been generally well tolerated in clinical trials.

Intravenous administration of vitamin C of doses over mg produces much higher blood concentrations of ascorbate than oral administration of the same dose.

Supplementation with vitamin C alone as ascorbate versus ascorbate formulations plus standard cancer therapies have been shown to be well tolerated in clinical trials.

Two studies of high-dose vitamin C in cancer patients reported improved quality of life and decreases in cancer-related toxicities. Although early observations from preclinical and clinical trials of high-dose vitamin C with and without conventional cancer therapies appear promising and the therapy well tolerated, these studies have several limitations due to lack of rigor in trial design.

An overview. Nutr J 2: 7, Arch Pediatr 76 4 : , The role of ascorbic acid in host resistance.

Chem Biol Interact 9 4 : , Clinical trial of high-dose ascorbic acid supplements in advanced human cancer. A controlled trial. N Engl J Med 13 : , A randomized double-blind comparison.

N Engl J Med 3 : , Ann Intern Med 7 : , Ann Oncol 19 11 : , Free Radic Biol Med 47 1 : , PLoS One 5 7 : e, In Vitro Studies Numerous studies have demonstrated that pharmacological doses of ascorbic acid 0.

Free Radic Biol Med 51 3 : , Cancer Chemother Pharmacol 67 5 : , Anticancer Drugs 23 4 : , Clin Cancer Res 16 2 : , Free Radic Biol Med 50 11 : , Biomed Pharmacother 64 5 : , Nutr Cancer 63 7 : , Biochem Biophys Res Commun 2 : , Mol Med Report 5 6 : , Biochim Biophys Acta 2 : , Adv Nutr 2 2 : , Cancer Cell 32 2 : , Redox Biol , Science : , Oncogene 32 12 : , Int J Oncol 38 6 : , Toxicol In Vitro 25 8 : , Free Radic Biol Med 52 8 : , Cancer Res 68 19 : , Leukemia 23 9 : , Cancer Cell 12 3 : , In Vivo 24 3 : , May-Jun.

J Transl Med 7: 70, Sci Transl Med 6 : ra18, Early Case Series Studies and Clinical Trials With Ascorbate Only In the early s, a consecutive case series was conducted in which 50 advanced-cancer patients were treated with large doses of ascorbic acid.

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