Folate, folic acid, and chemotherapy-induced toxicities: A systematic literature review

Nienke R. K. Zwart, Mira D. Franken, Wim J. E. Tissing, Floor J. E. Lubberman, Jill McKay, Ellen Kampman, Dieuwertje E. Kok*

*Corresponding author for this work

Research output: Contribution to journalLiterature reviewpeer-review

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Folate metabolism is a target for various chemotherapeutic drugs. Folate and its synthetic variant folic acid are B-vitamins. To what extent these vitamins impact treatment tolerance in patients with cancer remains unclear. A systematic literature review was conducted on intake and status of folate and folic acid in relation to chemotherapy-induced toxicities in children and adults with cancer. A total of 6231 publications were identified, of which 40 publications met the inclusion criteria. In 12 out of 22 studies focusing on antifolates, a deficient folate status and lower folate and folic acid intake were associated with a higher risk of toxicities. In 8 out of 14 studies focusing on fluoropyrimidine treatments, a higher folate status and intake were associated with a higher risk of toxicities. These findings might explain interindividual differences in treatment tolerance and highlight the importance of evaluating nutritional status in oncology care.

Original languageEnglish
Article number104061
JournalCritical reviews in oncology/hematology
Early online date21 Jun 2023
Publication statusPublished - 1 Aug 2023

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