Summary:
Dichloroacetate (DCA) is an investigational drug for cancer. DCA acts primarily on cancer cell metabolism; it is thought to convert metabolism from fermentative glycolysis back to oxidative phosphorylation by inhibiting pyruvate dehydrogenase kinase. This process may induce cancer cell apoptosis through several mechanisms including increased oxidative stress and reduced lactate levels. DCA can be administered orally or intravenously. Typical doses range from 10-50mg/kg daily, with the most common oral dosing being 6.25- 12.5mg/kg taken twice daily. One randomized controlled trial, five single-arm clinical trials, and several case reports have evaluated the effect of DCA in cancer. Outcomes in these studies have been mixed. Although most studies have found DCA to be safe and reasonably well tolerated, one study and a couple of case reports have raised some safety concerns. DCA should be administered under the guidance of a qualified healthcare professional with appropriate monitoring. The most common side effect is reversible peripheral neuropathy. There is some clinical trial evidence of disease stability with the use of DCA and a few encouraging case reports, but overall, there is insufficient evidence to clearly support the efficacy of DCA as a cancer treatment. More research is needed to determine the efficacy of DCA in cancer.