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

doi:10.1016/j.critrevonc.2023.104061

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 journal › Literature review › peer-review

18 Citations (Scopus)

406 Downloads (Pure)

Abstract

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 language	English
Article number	104061
Journal	Critical reviews in oncology/hematology
Volume	188
Early online date	21 Jun 2023
DOIs	https://doi.org/10.1016/j.critrevonc.2023.104061
Publication status	Published - 1 Aug 2023

Keywords

Folate
Cancer
Toxicity
Folic acid
Chemotherapy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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1-s2.0-S104084282300149X-mainFinal published version, 1.7 MBLicence: CC BY

Cite this

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

abstract = "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.",

keywords = "Folate, Cancer, Toxicity, Folic acid, Chemotherapy",

author = "Zwart, \{Nienke R. K.\} and Franken, \{Mira D.\} and Tissing, \{Wim J. E.\} and Lubberman, \{Floor J. E.\} and Jill McKay and Ellen Kampman and Kok, \{Dieuwertje E.\}",

note = "Funding information: This work is supported by a grant of the Dutch Research Council (016. Veni.188.082) to D.E. Kok. Funding for grant number IIG\_Full\_2021\_023 was obtained from Wereld Kanker Onderzoek Fonds (WKOF) as part of the World Cancer Research Fund International grant programme.",

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doi = "10.1016/j.critrevonc.2023.104061",

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T2 - A systematic literature review

AU - Zwart, Nienke R. K.

AU - Franken, Mira D.

AU - Tissing, Wim J. E.

AU - Lubberman, Floor J. E.

AU - McKay, Jill

AU - Kampman, Ellen

AU - Kok, Dieuwertje E.

N1 - Funding information: This work is supported by a grant of the Dutch Research Council (016. Veni.188.082) to D.E. Kok. Funding for grant number IIG_Full_2021_023 was obtained from Wereld Kanker Onderzoek Fonds (WKOF) as part of the World Cancer Research Fund International grant programme.

PY - 2023/8/1

Y1 - 2023/8/1

N2 - 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.

AB - 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.

KW - Folate

KW - Cancer

KW - Toxicity

KW - Folic acid

KW - Chemotherapy

UR - https://www.scopus.com/pages/publications/85163210780

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DO - 10.1016/j.critrevonc.2023.104061

M3 - Literature review

C2 - 37353179

SN - 1879-0461

VL - 188

JO - Critical reviews in oncology/hematology

JF - Critical reviews in oncology/hematology

M1 - 104061

ER -

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

Abstract

Keywords

UN SDGs

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