Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer

Aldoori, Joanna; Cockbain, Andrew J.; Toogood, Giles J.

doi:10.1136/gutjnl-2021-326362

Cited by 19 publications

(9 citation statements)

References 111 publications

(240 reference statements)

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“…The findings of the present work are supported by previous studies reporting that omega-3 PUFA causes selective cytotoxicity towards cancer cells with little or no toxicity on normal cells [41,42]. EPA and DHA have been described to induce apoptosis in vitro in tumor cell lines derived from a wide range of tumors, including colorectal carcinoma [43][44][45], esophageal [46], pancreatic cancer [47], and lung cancer [48], among others. The differences between the two lipid extracts in terms of cytotoxic effects exhibited by the SRB and LDH assay could be related to the composition of the extract.…”

Section: Cytotoxic Activity Of Lipid Extracts From Nannochloropsis Ga...supporting

confidence: 89%

Fatty Acid Composition and Cytotoxic Activity of Lipid Extracts from Nannochloropsis gaditana Produced by Green Technologies

Castejón

Marko

2022

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Microalgae are alternatives and sustainable sources of omega-3 long chain-polyunsaturated fatty acids (LC-PUFA). However, the eco-friendly extraction of these bioactives remains unexplored. In this work, the use of enzyme-based methods in combination with ultrasounds was evaluated as green approaches to extract the omega-3 lipids from Nannochloropsis gaditana. Three commercial enzymatic solutions (Viscozyme® L, Celluclast® 1.5 L, and Saczyme®) were investigated, and results were compared with the traditional Folch method. A promising extraction approach was developed by using Saczyme®, achieving a lipid yield of 25.7% ± 0.5, comparable to the traditional method (27.3% ± 0.7) (p > 0.05). Similar omega-3 content was found by GC–MS analysis for both lipid extracts (30.2% ± 2.4 and 29.3% ± 0.8 for the green and the traditional method, respectively), showing that the green approaches did not affect the fatty acid profile. Moreover, the cytotoxic activity of produced lipids was assessed by comparing human colon cancer cells (HCT-116) and epithelial nontumorigenic immortalized cells (HCEC-1CT). Results suggest that the lipid extracts have a selective effect, reducing the viability of the colon carcinoma cells but not the nontumorigenic cells. Thus, this study provides new eco-innovative approaches for extracting the omega-3 LC-PUFA from microalgae with promising biological properties.

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Section: Cytotoxic Activity Of Lipid Extracts From Nannochloropsis Ga...supporting

confidence: 89%

Fatty Acid Composition and Cytotoxic Activity of Lipid Extracts from Nannochloropsis gaditana Produced by Green Technologies

Castejón

Marko

2022

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“…In full cycle CRC-BMI management, various types of complementary therapies with low side-effects, such as acupuncture [ 147 , 148 ], Tai-Chi [ 149 , 150 ], yoga [ 151 , 152 ], Chinese herbal medicine [ 153 , 154 ], and probiotics [ 155 , 156 ], are recommended depending on the culture as well as the medical setting. Omega-3 fatty acids [ 157 ] are well evidenced and have potential to prevent cachexia. The vitamins [ 158 – 160 ] might also increase the survival rate.…”

Section: Discussion On Reviewed Knowledge and Datamentioning

confidence: 99%

Body mass index–based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM

Chen

et al. 2022

EPMA Journal

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Currently colorectal cancer (CRC) is the third most prevalent cancer worldwide. Body mass index (BMI) is frequently used in CRC screening and risk assessment to quantitatively evaluate weight. However, the impact of BMI on clinical strategies for CRC has received little attention. Within the framework of the predictive, preventive, and personalized medicine (3PM/PPPM), we hypothesized that BMI stratification would affect the primary, secondary, and tertiary care options for CRC and we conducted a critical evidence-based review. BMI dynamically influences CRC outcomes, which helps avoiding adverse treatment effects. The outcome of surgical and radiation treatment is adversely affected by overweight (BMI ≥ 30) or underweight (BMI < 20). A number of interventions, such as enhanced recovery after surgery and robotic surgery, can be applied to CRC at all levels of BMI. BMI-controlling modalities such as exercise, diet control, nutritional therapy, and medications may be potentially beneficial for patients with CRC. Patients with overweight are advised to lose weight through diet, medication, and physical activity while patients suffering of underweight require more focus on nutrition. BMI assists patients with CRC in better managing their weight, which decreases the incidence of adverse prognostic events during treatment. BMI is accessible, noninvasive, and highly predictive of clinical outcomes in CRC. The cost–benefit of the PPPM paradigm in developing countries can be advanced, and the clinical benefit for patients can be improved with the promotion of BMI-based clinical strategy models for CRC.

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“…In summary, given the promising preliminary data supporting anticancer activity of EPA, 20 including possible survival benefit for patients with CRCLM, 12 and the excellent safety and tolerability profile of EPA, 8 we tested the hypothesis that oral treatment with high-dose (4 g daily) pure EPA ethyl ester, started before surgery and continued long-term after liver resection for CRCLM, decreases CRC recurrence and/or improves OS and quality of life, in patients with advanced CRC.…”

Section: Introductionmentioning

confidence: 99%

Randomised, placebo-controlled, phase 3 trial of the effect of the omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) on colorectal cancer recurrence and survival after surgery for resectable liver metastases: EPA for Metastasis Trial 2 (EMT2) study protocol

Hull,

Ow,

Ruddock

et al. 2023

BMJ Open

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IntroductionThere remains an unmet need for safe and cost-effective adjunctive treatment of advanced colorectal cancer (CRC). The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) is safe, well-tolerated and has anti-inflammatory as well as antineoplastic properties. A phase 2 randomised trial of preoperative EPA free fatty acid 2 g daily in patients undergoing surgery for CRC liver metastasis showed no difference in the primary endpoint (histological tumour proliferation index) compared with placebo. However, the trial demonstrated possible benefit for the prespecified exploratory endpoint of postoperative disease-free survival. Therefore, we tested the hypothesis that EPA treatment, started before liver resection surgery (and continued postoperatively), improves CRC outcomes in patients with CRC liver metastasis.Methods and analysisThe EPA for Metastasis Trial 2 trial is a randomised, double-blind, placebo-controlled, phase 3 trial of 4 g EPA ethyl ester (icosapent ethyl (IPE; Vascepa)) daily in patients undergoing liver resection surgery for CRC liver metastasis with curative intent. Trial treatment continues for a minimum of 2 years and maximum of 4 years, with 6 monthly assessments, including quality of life outcomes, as well as annual clinical record review after the trial intervention. The primary endpoint is CRC progression-free survival. Key secondary endpoints are overall survival, as well as the safety and tolerability of IPE. A minimum 388 participants are estimated to provide 247 CRC progression events during minimum 2-year follow-up, allowing detection of an HR of 0.7 in favour of IPE, with a power of 80% at the 5% (two sided) level of significance, assuming drop-out of 15%.Ethics and disseminationEthical and health research authority approval was obtained in January 2018. All data will be collected by 2025. Full trial results will be published in 2026. Secondary analyses of health economic data, biomarker studies and other translational work will be published subsequently.Trial registration numberNCT03428477.

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Omega-3 polyunsaturated fatty acids: moving towards precision use for prevention and treatment of colorectal cancer

Cited by 19 publications

References 111 publications

Fatty Acid Composition and Cytotoxic Activity of Lipid Extracts from Nannochloropsis gaditana Produced by Green Technologies

Fatty Acid Composition and Cytotoxic Activity of Lipid Extracts from Nannochloropsis gaditana Produced by Green Technologies

Body mass index–based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM

Randomised, placebo-controlled, phase 3 trial of the effect of the omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) on colorectal cancer recurrence and survival after surgery for resectable liver metastases: EPA for Metastasis Trial 2 (EMT2) study protocol

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