大剂量维生素 C(HVC)治疗是一种相对安全和廉价的肿瘤治疗方法,能够通过促氧化应激、表观遗传修饰、抑制缺 氧诱导因子(HIF-α)和免疫调控等途径产生抗肿瘤作用,然而,HVC 单独应用仅对肿瘤有较弱的抑制作用,同时,治疗效果与 肿瘤代谢表型有密切关系。 HVC 对 KRS / BRAF、HIF、TETs/ IDH/ WT1 突变和 OMM Cyb5R3 / VDAC1 复合体、维生素 C 转运体高 表达的肿瘤治疗敏感,而对 KRS / BRAF 低表达的肿瘤无明显抑制效应,说明 HVC 需要针对肿瘤代谢表型进行精准治疗。 大剂 量维生素组合、维生素 C 纳米化、溶瘤病毒、程序性死亡受体 1(PD-1) / 程序性死亡配体 1(PD-L1)单克隆抗体等免疫检查点 抑制剂、放射治疗、细胞毒性药物治疗、中医中药等可明显提高 HVC 治疗肿瘤效果,提示精准强化治疗是 HVC 治疗重要研究 方向,但需要更多的临床试验证据支撑。

High-dose vitamin C HVC therapy is a safe and inexpensive anticancer treatment which could cure cancers by promoting oxidative stress epigenetic modification inhibiting HIF-α and immune regulation. However clinical practice has shown that there is only a "weak" inhibitory effect on cancers in high-dose vitamin C application alone. Moreover the anticancer effect of high-dose vitamin C is closely related to the metabolic phenotype. Cancers with mutations in KRS / BRAF HIF TETs/ IDH/ WT1 and high expression of OMM Cyb5R3 / VDAC1 complex or vitamin C transporters are sensitive to HVC treatment. However high -dose vitamin C had no obvious inhibitory effect on tumors with low KRS / BRAF expression suggesting that high-dose vitamin C should be targeted at tumor metabolic phenotype for precise treatment. On the other hand some preclinical trials have shown that there are some methods could improve the anticancer efficacy such as HVC combined with other kinds of vitamin vitamin C nano-crystallization oncolytic virus programmed death receptor - 1 / programmed death ligand - 1 monoclonal antibody and other immune checkpoint inhibitors radiotherapy cytotoxic drug therapy or traditional Chinese medicine etc. It is suggested that precise intensive therapy is an important research direction of high dose vitamin C therapy for tumor but more clinical evidence is still needed.