Key Findings
Flaxseed was assessed for its anti-oxidant and anti- inflammatory effects on locally-advanced Non-Small Cell Lung Cancer (NSCLC) which is treated by Radiation Therapy (RT) given with or without chemotherapy and often resulting in Radiation Induced Lung Injury (RILI). Two urinary biomarkers of systemic oxidative stress, 8, 12 iso iPF2a VI isoprostane and 8 oxo 7, 8 dihydro 2 deoxyguanosine (8 oxo dGuo) were monitored in patients receiving chemoradiation. The study was terminated early as the baked muffin formulation used did not contasin the required levels of flaxseed. However, intial data showed trends toward reduced rates of pneumonitis and levels of isoprostane and 8 oxo dGuo. Though no conclusions can be made, there appears to be a riel for flaxseed to alleviate the oxidative stress associated with radiation induced esophagitis. Future clinical trials are encouraged.
ABSTRACT
The standard of care in Locally Advanced Non Small Cell Lung Cancer (LANSCLC) is chemotherapy and radiation; however, Radiation Induced Lung Injury (RILI), which may be prevented by the anti inflammatory and anti oxidant properties of Flaxseed (FS), impedes its maximum benefit. Patients with LA NSCLC requiring definitive RT were randomized to one FS or control muffin daily from start to 2 weeks after RT. Blood and urine were collected to quantify plasma FS metabolites, Enterodione (ED) and Enterolactone (EL), and urinary oxidative stress biomarkers, 8, 12 iso iPF2a VI (isoprostane) and 8 oxo 7,8 dihydro 2 deoxyguanosine (8 oxo dGuo). Tolerability was defined as consuming less than or equal to 75 per cent of the intended muffins and no more than grade 3 gastrointestinal toxicities. Fourteen patients (control, 7; FS, 7) were enrolled. The tolerability rates were 42.9 versus 71.4 per cent for FS and control, respectively. Mean percentages of intended number of muffins consumed were 37 per cent versus 73 per cent. ED and EL increased at onset of FS and decreased with discontinuation, confirming bioavailability. Isoprostane and 8 oxo dGuo were detectable. There was a trend towards decreased rates of pneumonitis in FS. This is the first study to report FS bioavailability and quantify oxidative stress markers in NSCLC patients. FS in the administered muffin formulation did not meet tolerability criteria. Given the promising mechanism of FS as a radioprotectant, further investigations should focus on the optimal method for administration of FS. (Authors abstract)
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