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    ARTICLE

    A Pilot Study of Silymarin as Supplementation to Reduce Toxicities in Metastatic Colorectal Cancer Patients Treated With First-Line FOLFIRI Plus Bevacizumab

    Tsung-Kun Chang*†, Tzu-Chieh Yin‡§, Wei-Chih Su*†, Hsiang-Lin Tsai, Ching-Wen Huang, Yen-Cheng Chen*, Ching-Chun Li*, Po-Jung Chen*, Cheng-Jen Ma, Kuo-Hsiang Chuang#, Tian-Lu Cheng**, Jaw-Yuan Wang*†¶††‡‡§§

    Oncology Research, Vol.28, No.7-8, pp. 801-809, 2020, DOI:10.3727/096504021X16218531628569

    Abstract Irinotecan, a topoisomerase inhibitor, is a common cytotoxic agent prescribed for metastatic colorectal cancer (mCRC) patients. Diarrhea is the most common adverse event (AE). The underlying mechanism of irinotecaninduced diarrhea is intestinal mucosal damage caused by SN-38 (active metabolite of irinotecan) hydrolyzed from SN-38G (inactive metabolite) by bacterial -glucuronidase ( G). According to an animal study, silymarin reduces the activity of bacterial G without impairing antitumor efficacy. We conducted a prospective openlabel pilot study to evaluate the effect of silymarin as supplementation in reducing toxicities of mCRC patients undergoing irinotecan-based chemotherapy. We enrolled and randomized More >

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