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Patch can also hinder chemotherapy effect

By V. UPENDER RAO
Published August 7, 2006

According to a study published in the online version of the Proceedings of the National Academy of Science, nicotine supplements blunt the lethal effect that chemotherapy delivers to lung cancer cells.

This finding might explain why some patients with lung cancer who continue to smoke do not benefit as much from chemotherapy as those who stop smoking.

Researchers tested the cell-killing ability of three commonly used chemotherapeutic drugs, Cisplatin, Taxol and Gemzar, against non-small-cell lung cancer cell lines in the presence of nicotine. Piali Dasgupta, a postdoctoral fellow at the H. Lee Moffitt Cancer Center, said that, nicotine induces angiogenesis (new blood vessel formation) and suppresses apoptosis (cell death).

In this manner, nicotine enhances blood supply and facilitates tumor cell growth while suppressing apoptosis, a process through which chemotherapy induces cancer cell death.

She explained that nicotine regulates two genes, X1AP and survivin, which protect cancer cell death due to apoptosis. By silencing these two genes, researchers were able to eliminate nicotine's protective effect on cancer cells.

Although nicotine patches deliver less drug to the blood stream compared to cigarette smoking, it is still possible that it may blunt chemotherapy's effect against cancer cells.

These cell line findings have to be confirmed in human studies as well before making a standard recommendation against nicotine patches. In the meantime, it may be prudent to try other methods of smoking cessation such as hypnosis and biofeedback. But the more important task is to get patients off cigarette smoking.

V. Upender Rao, MD, FACP, practices at the Cancer and Blood Disease Center in Lecanto.

[Last modified August 7, 2006, 06:14:55]