S-adenosylmethionine (AdoMet) supplementation for treatment of chemotherapy-induced liver injury.
BACKGROUND
Liver toxicity can be observed during treatment with most chemotherapic agents, and represents one of the principal causes of dose reduction or chemotherapy delays. S-Adenosylmethionine (AdoMet) plays a critical role in the synthesis of polyamines and provides cysteine for the production of glutathione (GSH), the major endogenous hepatoprotective agent. Our study was aimed at assessing the protective effect of AdoMet supplementation in cancer chemotherapy-induced liver toxicity.


METHODS
Fifty cancer patients who developed, for the first time, anticancer chemotherapy-induced liver toxicity were studied. Enrolled patients received oral AdoMet supplementation.


RESULTS
AST, ALT and LDH levels recorded at the moment of the recognition of liver toxicity were significantly reduced after one week of AdoMet therapy (respectively p: 0.009, 0.0005 and 0.012). AST, ALT and LDH decrease was confirmed after two weeks of treatment. Furthermore, the effect on these enzyme levels persisted in the following chemotherapy courses, permitting our patients to perform the scheduled chemotherapy courses with a minimal number of dose reductions or administration delays. The efficacy of AdoMet supplementation was not influenced by the presence of liver metastases, and no appreciable side-effects were recognized.


CONCLUSIONS
The results of our study clearly demonstrate a protective effect of AdoMet in cancer chemotherapy-induced liver toxicity. Further large phase III studies are required to assess the real clinical benefit associated with AdoMet supplementation.
Santini
Daniele
D
Medical Oncology, Center for Biomedical Research (CIR), Laboratory of Internal Medicine and Hepatology, Campus Bio-Medico University, Rome, Italy.
Vincenzi
Bruno
B
Massacesi
Cristian
C
Picardi
Antonio
A
Gentilucci
Umberto Vespasiani
UV
Esposito
Vincenzo
V
Liuzzi
Giuseppina
G
La Cesa
Annalisa
A
Rocci
Laura
L
Marcucci
Fabiana
F
Montesarchio
Vincenzo
V
Groeger
Angela M
AM
Bonsignori
Maurizio
M
Tonini
Giuseppe
G
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000378:metabolism; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008107:Liver Diseases / Q000201:enzymology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012436:S-Adenosylmethionine / Q000627:therapeutic use*
D012436:S-Adenosylmethionine; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase