Magnesium and Cancer

Nephrotoxicity

Several studies have demonstrated that magnesium administered during chemotherapy treatment has a protective effect against nephrotoxicity.

A double-blind, placebo-controlled phase 2 study randomly assigned 40 patients with epithelial ovarian cancer to receive magnesium sulphate (5 g) before each course of chemotherapy (paclitaxel plus cisplatin) with magnesium subcarbonate (500 mg 3 times per day) administered during treatment intervals.⁷ Magnesium supplementation was effective in increasing serum magnesium levels, and resulted in a significantly lower decrease in glomerular filtration rate (GFR) compared with placebo as indicated by serum creatinine (P = .0069), Cockroft-Gault (CICG; P = .0077), and Modification Diet of Renal Disease (MDRD; P = .032).

A study of 85 patients with lung cancer receiving cisplatin-based chemotherapy received high or low volume hydration with magnesium or high volume hydration without magnesium.⁸ The group that did not receive magnesium demonstrated a significant increase in serum creatinine and significant decrease in creatinine clearance compared with baseline. There was no difference in serum creatinine or creatinine clearance compared with baseline for patients who received high volume hydration with magnesium, and a trend toward increased serum creatinine and decreased creatinine clearance in the group that receive low volume hydration with magnesium.

A prospective cohort study evaluated magnesium (15 mEq) supplied as part of a prehydration regimen to 28 patients with cervical cancer receiving treatment with cisplatin.⁹ There was no significant change in serum creatinine or estimated GFR in the magnesium group compared with baseline. In the group that did not receive magnesium, however, there was a significant increase in serum creatinine and a significant decrease in the estimated GFR compared with baseline. 

Another prospective cohort study of 74 patients receiving cisplatin-based therapy for gynecologic cancer also demonstrated that prehydration with magnesium sulfate resulted in lower rates of moderate renal dysfunction classified as “risk” compared with patients who received prehydration without magnesium.¹⁰

Neurotoxicity

Several studies have evaluated the effect of calcium and magnesium infusions on oxaliplatin-induced neuropathy, which were summarized in a systematic review published in 2016.¹¹

The systematic review included 694 evaluable patients from 5 different trials. Results from pooled data demonstrated no significant difference in grade 2 or higher neuropathy between the patients who received calcium magnesium or controls.

Conclusions

Epidemiologic studies suggest that total magnesium intake may reduce the risk of CRC and pancreatic cancer.

Several studies, including a randomized controlled trial, suggest that prehydration with magnesium or magnesium supplementation is protective against cisplatin-induced nephrotoxicity. Magnesium in addition to calcium, however, does not appear to be protective against chemotherapy-induced neurotoxicity.

References

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2. Larsson SC, Bergkvist L, Wolk A. Magnesium intake in relation to risk of colorectal cancer in women. JAMA. 2005;293:86-89.
3. Dai Q, Shrubsole MJ, Ness RM, et al. The relation of magnesium and calcium intakes and a genetic polymorphism in the magnesium transporter to colorectal neoplasia risk. Am J Clin Nutr. 2007;86:743-751.
4. Gorczyca AM, He K, Xun P, et al. Association between magnesium intake and risk of colorectal cancer among postmenopausal women. Cancer Causes Control. 2015;26:1761-1769. doi: 10.1007/s10552-015-0669-2.
5. Lin J, Cook NR, Lee IM, et al. Total magnesium intake and colorectal cancer incidence in women. Cancer Epidemiol Biomarkers Prev. 2006;15:2006-2009. doi: 10.1158/1055-9965.EPI-06-0454.
6. Dibaba D, Xun P, Yokota K, et al. Magnesium intake and incidence of pancreatic cancer: the VITamins and Lifestyle study. Br J Cancer. 2015;113:1615-1621. doi: 10.1038/bjc.2015.382.
7. Bodnar L, Wcislo G, Gasowska-Bodnar A, et al. Renal protection with magnesium subcarbonate and magnesium sulphate in patients with epithelial ovarian cancer after cisplatin and paclitaxel chemotherapy: a randomized phase II study. Eur J Cancer. 2008;44:2608-2614. doi: 10.1016/j.ejca.2008.08.005.
8. Oka T, Kimura T, Suzumura T, et al. Magnesium supplementation and high volume hydration reduce the renal toxicity caused by cisplatin-based chemotherapy in patients with lung cancer: a toxicity study. BMC Pharmacol Toxicol. 2014;15:70-79.
9. Yamamoto Y, Watanabe K, Tsukiyama I, et al. Nephroprotective effects of hydration with magnesium in patients with cervical cancer receiving cisplatin. Anticancer Res. 2015;35:2199-2204.
10. Yamamoto Y, Watanabe K, Tsukiyama I, et al. Hydration with 15 mEq magnesium is effective at reducing risk for cisplatin-induced nephrotoxicity in patients receiving cisplatin (≥50 mg/m2) combination chemotherapy. Anticancer Res. 2016;36:1873-1877.
11. Jordan B, Jahn F, Beckmann J, et al. Calcium and magnesium infusions for the prevention of oxaliplatin-induced peripheral neurotoxicity: a systematic review. Oncology. 2016;90:299-306. doi: 10.1159/000445977.