Effects of Omega-3 Supplementation on Ki-67 and VEGF Expression Levels and Clinical Outcomes of Locally Advanced Breast Cancer Patients Treated with Neoadjuvant CAF Chemotherapy: A Randomized Controlled Trial Report

Abstract

Background: Omega-3 is a polyunsaturated fatty acid with an ability to regulate cell proliferation and apoptosis<br />through interaction with inflammatory mediators. The potential additional beneficial effects of Omega-3 on chemotherapy<br />patients with breast cancer is not yet completely revealed. Methods: A double-blind randomized control trial (RCT)<br />involving a total of 48 locally advanced breast cancer patients was conducted. Ki-67 and VEGF expressions, as well as<br />overall survival of patients receiving neoadjuvant cyclophosphamide-doxorubicin-5'fluorouracyl (CAF) chemotherapy<br />plus Omega-3 (intervention group) or placebo (control group), were compared. Kaplan-Meier curve and Cox-regression<br />tests were used to assess conditional disease-free survival (DFS) and overall survival (OS) between the two groups.<br />Results: Decreased Ki-67 expression was observed in the intervention group compared to control (42.4±4.8 versus<br />39.2±5.3; T-test p=0.032). Decreased Ki-67 expression was observed in intervention compared to control group (42.4±4.8<br />versus 39.2±5.3; T-test p=0.032). Decreased VEGF expression was also seen in the intervention group compared to<br />control (32.7±5.2 versus 29.5±5.4; T-test p=0.041). VEGF expression positively correlated with Ki-67 expression<br />(Spearman's test p<0.001, R2=0.541). Overall survival in the intervention group was significantly longer in comparison<br />to the control group (mean survival: 30.9 ± 3.71 versus 25.9 ± 3.6 weeks, Mantel-Cox test p=0.048; HR=0.411, 95%CI:<br />0.201-0.840). Disease-free survival was significantly longer in the intervention group compared to the control group<br />(mean survival: 28.5 ± 3.3 versus 23.7 ± 3.6, respectively; Mantel-Cox test p=0.044, HR= 0.439, 95%CI: 0.222-0.869).<br />Conclusion: Omega-3 fatty acid supplementation improved overall survival and progression-free survival of locally<br />advanced breast cancer treated with CAF neoadjuvant chemotherapy and mastectomy.