Vitamin B₂: a promising adjuvant in Cisplatin based chemotherapy in cancer treatment

Introduction: Cisplatin (CP) is one of the most valued anticancer drugs against various formsof cancer, but it exerts many side effects, often resulting in the withdrawal of clinical usageduring long-term chemotherapy. Its toxicological properties and photosensitizing propertiesmake riboflavin (RF) a potential adjuvant in chemoradiotherapy. This review discusses apromising adjuvant in cisplatin-based chemotherapy in cancer treatment.Method and Materials: This study was performed using the collected article in English thatwere available on details of the main topic from ۲۰۰۰ to ۲۰۲۱ in Scopus, PubMed, and Web ofScience with keyword adjuvant therapy, cancer, riboflavin, cisplatin. Articles were selectedbased on the exclusion criteria and, after reviewing, were included in the study.Results: Cisplatin is a widely used antineoplastic agent for treating metastatic tumors,advanced bladder cancer, and many other solid tumors. CP blocks primary EMT and preventsbreast cancer metastasis. In a higher dose (۶ mg/kg), this drug inhibits the growth andmetastasis of cancer. However, it causes strong side effects such as severe kidney problems,allergic reactions, reduced immunity against infections, digestive disorders, bleeding, andhearing loss. A lower dose (۲ mg/kg) can prevent cancer metastasis without fatal complicationsbut for a more extended period. Results show that in the intraperitoneal injection of cisplatinand simultaneous treatment with vitamin B۱۲ for five weeks, the toxicity and side effects ofthe drug are reduced. Also, using vitamin B۱۲ made it possible to start standard chemotherapyfaster. According to the studies, increasing the amount of vitamin B۱۲ supplements causes therisk of chronic diseases and cancer (especially lung cancer); on the other hand, the lack of Bvitamins leads to disruption of the integrity of breast epithelial cells. In patients with locallyadvanced bladder cancer, combination cisplatin-based neoadjuvant therapy may be beneficial.The antioxidant properties of riboflavin are either involved in decreasing stress directly, byreplenishing cellular reductants and antioxidant enzymes, or by halting the derogatory,inflammatory response caused by CP. Thus, riboflavin can induce apoptosis and autophagyand can be helpful in managing cancer treatment under chemoradiotherapy. It also downregulatesmany anti-apoptotic factors like P۱۳ K, JNK, and ERK K phosphorylation .Conclusion: It has been very encouraging to observe that RF ameliorated the significant toxiceffects of CP, such as nephrotoxicity, hepatotoxicity, and neurotoxicity. This strategy canincrease the average life span of cancer patients and improve their quality of life significantly

کلیدواژه ها:

adjuvant therapy ، cancer ، riboflavin ، cisplatin