Written by Helen Cooke, Helen Seers and the CAM-Cancer Consortium.
Updated September 21, 2011

Co-enzyme Q10

Does it work?

Does CoQ10 work as an anti-cancer agent?

Controlled clinical studies

Italian researchers who conducted a three year (non-randomised) study with a sample of melanoma patients (n=81) found that the group treated with CoQ10 alongside interferon reported improved quality of life (favourable mood effects, reduction in physical weakness and in the severity of tinnitus) compared to the control group who received interferon only. The patients with stage II melanoma in this group also appeared to have a lower rate of recurrence. Further trials with more patients are being undertaken by this research team 46.The same researchers concluded that plasma CoQ10 levels are a powerful and independent prognostic factor and can be used to estimate the risk for melanoma progression 47. A trial by a team of Indian researchers using CoQ10 in a group of women (n=210) undergoing tamoxifen treatment reported reduced levels of angiogenesis markers 39.

Uncontrolled clinical studies

One uncontrolled study in Denmark followed the progress of 32 people with breast cancer for 18 months who were given antioxidant supplements including CoQ10 after or concomitantly with conventional anticancer treatment 12. At the end of this period, six people were in remission and all of the 32 were alive and reporting improved quality of life, less painkiller use and less weight loss. In a follow-up study, all 32 people were alive at 24 months 13.

Case reports

In a different study conducted by the same researchers, three people with breast cancer and taking high doses of CoQ10 were investigated for three to five years 14. All three experienced remission.

A case history review documented anecdotal reports of CoQ10 suggesting a positive survival effect on people with different cancers 11.

Overall there is no evidence to support CoQ10 working as an anti-cancer agent. The above controlled trials 39,46-47 were not high-quality randomised clinical trials and in the uncontrolled clinical studies and case reports 12-14 control groups were not used, patients were also taking supplements other than CoQ10, and effective anticancer treatments were also given.

Clinical trials of analogues of CoQ10 and CoQ10 combination products

Trials in which CoQ10 is used as part of a supplement combination appears to show some anti-cancer benefit 36-38 and improved blood chemistry profile 40-42, although an earlier trial did not show benefit 35.

Pre-clinical studies

There is some preliminary evidence from laboratory and animal studies that chemicals very similar to CoQ10 (analogues of CoQ10) 9-10 and CoQ10 used as part of an antioxidant combination 43-45 have anti-cancer effects.

Does CoQ10 work as a protector against adverse effects of chemotherapeutic agents?

Reviews

A Cochrane systematic review reported that no definite conclusions can be made about the efficacy of different cardioprotective agents for cancer patients receiving anthracyclines 48. It only included one study on CoQ10, however, that is reported below by Iarussi et al. 23.

A 2008 review by Nicolson and Conklin stated that, although limited in number, clinical studies support pre-clinical data that suggests CoQ10 protects the heart from the cardiotoxicity of anthracyclines. They noted that the impact of CoQ10 on the anti-neoplastic efficacy of anthracycline-based chemotherapy has not yet been studied 49.

A review by Roffe et al. 18 states that there is some evidence of a protective benefit from CoQ10, however, the authors conclude that the studies reviewed are all methodologically flawed and the results not conclusive. The article reviewed several pre-clinical and clinical studies, although the numbers of people included in the clinical studies were small (maximum n=80), so the results need to be interpreted with caution. The review stated that many unanswered questions remain about the use of CoQ10 alongside anthracycline. Little is known about how long these effects can last for or the best way to administer CoQ10 (what levels should be taken/should it be administered with food etc). Most importantly, little is still known about how it may affect the anti-tumour activity of anthracycline 51.

Bryant et al. conducted a systematic review to evaluate technologies to reduce anthracycline-induced cardiotoxicity in children. The review presented the results of one study that reported a protective effective of CoQ10 on cardiac function 52.

Controlled clinical trials

Several trials have looked at whether CoQ10 protects against chemotherapy induced cardiotoxicity.

Takimoto et al. 19 conducted a small randomised clinical trial (n = 40) on lung, breast and thyroid patients treated with doxorubicin chemotherapy. The experimental group was given CoQ10 and the patients were found to have improved heart capacity compared to the control group. However, no significant difference in arrhythmia frequency or other indicators of heartbeat malfunction were seen.

Akihama et al. 20 also conducted a small (n = 19) placebo-controlled, double-blind study with leukaemia and lymphoma patients taking anthracycline and also CoQ10 in the experimental group. No significant difference between control and experimental groups was found.

In another randomised clinical trial, Okuma et al. 21 studied a relatively large group of participants (n = 80) with a range of different cancers. They found CoQ10 had a significant stabilising effect on the heart.

In 1986, Lucarelli et al. 22 found CoQ10 to have a beneficial effect against anthracycline cardiotoxicity in a controlled clinical trial with 30 haematological cancer patients. This small study did, however, not report any statistics for any significant effects.

Iarussi et al. 23 conducted a small randomised clinical trial (n = 20) to look at the protective effect of CoQ10 in leukaemia and lymphoma patients’ heart function. They found less heart damage for the CoQ10 group, but crucially did not report any statistics for this, thereby not demonstrating whether CoQ10 had a therapeutic effect This study has further methodological limitations; both the participants and the providers were not blinded to the treatment 48.

Pre-clinical data

Animal evidence supporting the cardioprotective effects of CoQ10 has been seen on the heart muscles of mice, rats and rabbits given chemotherapy (Adriamycin) 15 and Doxorubicin 58. However, the same positive benefit was not found in another study with Adriamycin 16 and also radiotherapy 17. A further mice study concluded that CoQ10 ameliorated acute cystoplatin nephrotoxicity 59.

It therefore appears that although there is some evidence that CoQ10 works as a protector against adverse effects of several chemotherapeutic drugs, further higher quality trials are still needed to confirm this.

Citation

Helen Cooke, Helen Seers, CAM-Cancer Consortium. Co-enzyme Q10 [online document]. http://www.cam-cancer.org/CAM-Summaries/Dietary-approaches/Co-enzyme-Q10. September 21, 2011.

Document history

Most recent revision and update in September 2011 by Helen Cooke.
Fully revised and updated in August 2009 by Helen Cooke.
First published in 2005, authored by by Helen Seers and Helen Cooke.

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