# Efficacy of vitamin C on chemotherapy-related anemia in pancreatic cancer: study protocol for a randomized controlled trial

## TL;DR

This study will test if adding vitamin C to chemotherapy improves quality of life for advanced pancreatic cancer patients by reducing anemia and other side effects.

## Contribution

The first randomized controlled trial to investigate vitamin C's effect on chemotherapy-related anemia and quality of life in metastatic pancreatic cancer.

## Key findings

- The trial will assess anemia rates in patients receiving chemotherapy with or without vitamin C.
- Secondary outcomes include neuropathy, pain, quality of life, and survival in the treatment groups.

## Abstract

In the treatment of advanced pancreatic cancer, chemotherapy plays a pivotal role. Despite its effectiveness, this regimen is often marred by side effects such as anemia, neuropathy, fatigue, nausea, and malnutrition, which significantly affect patients’ tolerance to the treatment. Some studies have shown that vitamin C could potentially augment chemotherapy’s tolerability, notably by boosting iron absorption, ameliorating anemia, and relieving pain and numbness in hands and feet. Nevertheless, the integration of vitamin C with chemotherapy to mitigate toxic side effects and enhance the quality of life for advanced pancreatic cancer patients has not been examined in any randomized controlled trials to date.

A prospective, single-center, open-label, randomized controlled trial will be conducted at Fudan University Shanghai Cancer Center from September 2023 to September 2026. A total of at least 100 patients with advanced pancreatic adenocarcinoma exhibiting distant metastases will be recruited and randomly assigned to the chemotherapy group or the chemotherapy plus vitamin C group. The primary endpoint is the rate of anemia. Secondary endpoints include the rate of grade 3 neuropathy, change of numeric rating scale, quality of life, and overall survival.

This study aims to assess the impact of low-dose vitamin C on enhancing the quality of life for patients with metastatic pancreatic cancer undergoing gemcitabine and nab-paclitaxel chemotherapy.

The trial was registered with the ClinicalTrials.gov (NCT06018883) on August 31, 2023.