@Article{096504021X16218531628569,
AUTHOR = {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},
TITLE = {A Pilot Study of Silymarin as Supplementation to Reduce Toxicities  in Metastatic Colorectal Cancer Patients Treated With First-Line  FOLFIRI Plus Bevacizumab},
JOURNAL = {Oncology Research},
VOLUME = {28},
YEAR = {2020},
NUMBER = {7-8},
PAGES = {801--809},
URL = {http://www.techscience.com/or/v28n7-8/48469},
ISSN = {1555-3906},
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 70 mCRC patients receiving first-line 
FOLFIRI (5-fluorouracil/leucovorin/irinotecan) plus bevacizumab. In each treatment cycle, the study group 
was administered silymarin capsules (150 mg) three times daily for 7 days. The study group experienced less 
AEs in diarrhea (5.7% vs. 14.6%, <i>p</i>=0.002) and nausea (27.0% vs. 40.2%, <i>p</i>= 0.005) in comparison with the 
control group, but no significant differences in hepatic toxicities were observed. In conclusion, simultaneous 
administration of silymarin is a potential effective supplementation for reducing toxicities in mCRC patients 
undergoing first-line FOLFIRI plus bevacizumab, especially in diarrhea and nausea.},
DOI = {10.3727/096504021X16218531628569}
}