To the editor,

The recent article by Chen et al. [1] provided for highly stimulating reading. Valproic acid mitigates tumor growth in a number of systemic malignancies besides gliomas.

Similar effects are seen in prostate carcinomas. Valproic acid causes augmentation of p27 levels leading to cell cycle arrest in the cancerous cells [2]. The expression of androgen receptors by the malignant tumor is also decreased. At the same time E-cadherin expression is augmented markedly [3]. Angiogenesis is also inhibited at the same time thus decreasing tumor growth. Cyclin D1 expression is also attenuated at the same time, while cytokeratin-18 expression is increased [4]. This results in a decrease in tumor invasiveness as well as a decline in cancer cell migration. Valproic acid also has an augmenting effect on the radio-sensitivity of prostate carcinomas [5]. It mediates this effect via acetylated p53 dependent modulation of mitochondrial membrane potential in the cancerous cells. Similar effects have been seen in bladder carcinomas. It mediates its anti-neoplastic effect in bladder tumors by inhibiting histone deacetylase [6]. Simultaneous up-regulation of thrombospondin-1 expression is also seen in bladder carcinomas.

Similarly, valproic acid inhibits tumor growth in colo-rectal malignancies. These effects are especially seen when it is used in combination with IIF. The dual combination enhances Bax expression while Bcl-2 expression is markedly reduced [7]. TIMP-1 activity is also enhanced at the same time, while MMP2 activity is considerably reduced. These effects are time dependent. The combination also markedly up-regulates the expression of RXRγ. Histone deacetylase activity is also markedly reduced. Valproic acid also augments the radio-sensitivity of colon carcinomas. p53 plays a major role in this valproic acid mediated radio-sensitization. It is clear from the above examples that valproic acid may have significant tumor attenuating effects. There is an urgent need to fully as well as further evaluate these anti-neoplastic effects.