ONC: Breast Cancer: Chemotherapy and Use of Arginine Oral Supplement 2007
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
ONC: Breast cancer: Arginine and Chemotherapy
Use of an oral arginine supplement to improve long-term clinical response for patients with breast cancer prior to the start of neoadjuvant chemotherapy is not currently recommended. Evidence is not available to evaluate the safety of arginine or its effect on cancer symptoms for patients with breast cancer receiving chemotherapy. One RCT demonstrated a statistically significant histopathological response in tumor sizes less than 6 cm, however there was no improvement in short-term clinical response.
Risks/Harms of Implementing This Recommendation
No potential risks or harms are associated with this recommendation.
Conditions of Application
No conditions limit the application of this recommendation.
Potential Costs Associated with Application
No obvious costs are associated with this recommendation.
- In a positive quality RCT (Heys et al, 1998) using oral L-arginine supplements in patients with breast cancer, the arginine supplemented group experienced no significant differences in clinical response as compared to the placebo group, however, there was a significant improvement in histopathological response in the study group vs. placebo in patients with initial tumor size less than 6 cm.
- More research is needed to establish the safety and efficacy of arginine for patients with breast cancer undergoing chemotherapy.
Recommendation Strength Rationale
- Based on one positive quality RCT, conclusion statement is a Grade III.
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
What is the relationship between the use of an arginine oral supplement and a reduction in cancer symptoms in patients with breast cancer?
Heys, S.D., Ogston, K., Miller, I., Hutcheon, A.W., Walker, L., Sarker, T.K., Dewar, J., Ah-See, A.K., Eremin, O.. Potentiation of the response to chemotherapy in patients with breast cancer by dietary supplementation with L-arginine: results of a randomised controlled trial. Int J Oncol. 1998 Jan;12(1):221-5.