randomized controlled trials

Synergy: doxycycline & vitamin C may be lethal to cancer stem cells

Synergy and new research with old ingredients: how antibiotics and vitamin C kill cancer stem cells

The study of T'ai Chi and biotensegrity both involve
synergy, wherein the combined effect is greater than the sum of the parts involved. Synergies create better value propositions; you get "more bang for the buck," "more bounce for the ounce," "more bling for your cha-ching."

With T'ai Chi, for example, numerous studies of the health benefits of T'ai Chi practice include a comment like, "although the exact mechanism is not well understood…"—meaning they know it works but they can't tell
why it works. No, you can't. Because it's not additive and it's not linear. There are emergent properties at work here, and it's synergistic.

In the natural world, most things work this way. Synergy is efficient; it maximizes effectiveness. Biotensegrity is the study of nature, and biology in particular, through the lens of tensegrity, itself a synergistic architectural principle revealing several emergent properties (auxeticity, mechanotransduction, helicity, visco-elasticity…). Here, as in T'ai Chi, synergy is the name of the game.

In traditional scientific research, however, randomized controlled trials tend not to have more than one parameter. Synergy, although apparent in many sciences and actively studied among them since the 1800's, does not seem to extend much into research. This is why some have proposed the alternative research strategy of
factorial randomized controlled trials. But science, justifiably, is a ship that turns slowly.

So, I always take particular delight when synergy presents itself in a new incarnation, especially when a simple combination of things that are relatively common and easily accessible is shown to be of potentially huge and immediate benefit to millions of people worldwide. I'm talking about a recent report showing that a combination of doxycycline and vitamin C can be a "lethal combination" for cancer stem cells.

Of course more research needs to be done. But sometimes, especially when there is more than one parameter to be tested, randomized controlled trials are trickier to coordinate, and may take years. Strategically, especially when the costs of NOT implementing the protocol may be quite high, the effects seem to be synergistic, and the interventions involved are considered relatively benign, the general public may prefer not to wait for them.

This was the case recently when the National Academies reported on three interventions which may, when combined, help to prevent or delay cognitive decline and dementia (see my previous blog article). Even though more testing needs to be done, the researchers felt that the public needed to be informed of the possible benefits immediately, so they could make their own choices regarding implementation of the relatively simple but potentially very highly effective three point strategy.

In the case of pairing doxycycline with vitamin C, we're talking about combining a readily available, inexpensive and commonly used vitamin with an antibiotic that is generically available, inexpensive, has a 50-year history of use, and is included in the
World Health Organization's List of Essential Medicines.

For scientific integrity, researchers need to proceed slowly; but informed citizens may choose whether they want to, or have time to, wait.

Here's the report, entitled
Vitamin C and Doxycycline: A synthetic lethal combination therapy targeting metabolic flexibility in cancer stem cells (CSCs), available on the Oncotarget website