Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Dithiolthiones, particularly 1,2-dithiol-3-thione derivatives such as oltipraz, have been studied for their potential to reduce chemotherapy side effects due to their antioxidant and chemoprotective properties. The primary scientific rationale comes from their ability to induce phase II detoxifying enzymes (e.g., glutathione S-transferases) via activation of the Nrf2 pathway, which can enhance cellular defense mechanisms against oxidative stress generated by chemotherapy agents. Several preclinical studies in animal models have demonstrated that dithiolthiones can protect normal tissues from chemotherapy-induced toxicity (such as nephrotoxicity and hepatotoxicity) without reducing the anti-cancer efficacy of the chemotherapeutic drugs. However, clinical evidence in humans is limited. While some early-phase clinical trials have investigated oltipraz as a chemopreventive agent or as support during chemotherapy, results have been inconclusive, with concerns about side effects at higher doses and inconsistent benefit in reducing chemotherapy toxicity. There is no widespread clinical adoption or guideline-based recommendation for the use of dithiolthiones to support chemotherapy in patients. Therefore, while there is a plausible mechanistic basis and promising preclinical data, human evidence remains limited and inconclusive, justifying a moderate-low rating of 2 out of 5 for the evidence supporting this use.

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