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Gallium

Also known as: Gallium, Ga, Gallium Maltolate (GaM), Gallium Nitrate

Overview

Gallium is a soft, silvery-white metal found in trace amounts in nature, typically as a byproduct of aluminum and zinc production. While not commonly used as a dietary supplement, gallium compounds have significant medical applications, particularly in cancer treatment and diagnostic imaging. Gallium nitrate is used to manage hypercalcemia associated with cancer, while gallium maltolate is being investigated for its antineoplastic properties. Gallium-68 is used in PET scans for prostate cancer detection. Gallium's mechanism of action involves disrupting iron metabolism in cancer cells by mimicking iron and binding to transferrin. Research on gallium compounds is mature, with high-quality evidence supporting their medical uses. Oral bioavailability is high for gallium maltolate, whereas gallium nitrate requires intravenous administration.

Benefits

Gallium nitrate is effective in reducing hypercalcemia in cancer patients, demonstrating superiority over some bisphosphonates in clinical trials. Gallium maltolate exhibits potent antineoplastic effects in preclinical models of glioblastoma, showing significant reductions in tumor growth. Gallium compounds may also inhibit bone turnover and reduce osteolysis in patients with bone metastases. These benefits are particularly relevant for patients with cancer-associated hypercalcemia and potentially for those with glioblastoma. Gallium-68 PSMA PET scans show high sensitivity and specificity for detecting prostate cancer metastases.

How it works

Gallium disrupts iron metabolism by mimicking iron and binding to transferrin, an iron-transport protein. This action inhibits iron uptake by cancer cells, which require iron for proliferation and survival. By interfering with iron metabolism, gallium can inhibit cancer cell growth and reduce tumor size. Gallium also affects bone metabolism, reducing osteolysis in patients with bone metastases. The interaction with transferrin and other iron-binding proteins is a key molecular target.

Side effects

Gallium is generally considered safe when used appropriately in medical settings, but side effects can occur. Gallium nitrate, administered intravenously, can cause renal impairment and hypophosphatemia. Gastrointestinal disturbances are potential but uncommon. Severe renal toxicity is a rare side effect with high doses of gallium nitrate. Drug interactions may occur with medications affecting kidney function. Gallium is contraindicated in patients with renal impairment. Caution is advised in patients with kidney disease. The side effect profile of oral gallium maltolate is not as well-documented as that of gallium nitrate.

Dosage

Gallium is not typically used as a dietary supplement, and therefore, there are no established dosages for general use. In medical applications, gallium nitrate is administered intravenously at a dose of 200 mg/m²/day for hypercalcemia. Gallium maltolate dosing is under investigation, with preclinical studies exploring various dosages. Due to potential toxicity, medical use requires careful dosing and monitoring. Continuous infusion may be used for gallium nitrate to minimize toxicity. Oral gallium maltolate offers advantages over intravenous gallium nitrate due to its bioavailability, potentially allowing for lower doses.

FAQs

Is gallium safe for daily use as a supplement?

Gallium is not typically used as a dietary supplement. Its use is primarily in medical settings under strict supervision due to potential side effects.

What are the primary medical uses of gallium?

Gallium compounds are used to treat hypercalcemia associated with cancer, and gallium maltolate is being researched for its antineoplastic properties. Gallium-68 is used in PET scans for prostate cancer detection.

How does gallium work against cancer?

Gallium disrupts iron metabolism in cancer cells by mimicking iron and binding to transferrin, thereby inhibiting iron uptake and hindering cancer cell growth.

What are the potential side effects of gallium?

Gallium nitrate can cause renal impairment and hypophosphatemia. Gastrointestinal disturbances are also possible. Severe renal toxicity is a rare but serious concern with high doses.

Is gallium maltolate better than gallium nitrate?

Gallium maltolate has high oral bioavailability, offering advantages over intravenous gallium nitrate. However, more research is needed to fully understand its efficacy and safety profile.

Research Sources

https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1278157/full – This preclinical study investigated the effects of gallium maltolate in a rat xenograft model of glioblastoma. The findings demonstrated significant antineoplastic effects with high oral bioavailability, suggesting potential for further research into gallium maltolate as a treatment for glioblastoma. The study provides high-quality preclinical data supporting the use of gallium maltolate in cancer therapy.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2898053/ – This article discusses the use of gallium nitrate in the treatment of hypercalcemia associated with cancer. Clinical trials have shown that gallium nitrate is effective in reducing hypercalcemia and is comparable or superior to bisphosphonates. The article highlights the well-established efficacy of gallium nitrate in clinical settings for managing hypercalcemia.
https://pubmed.ncbi.nlm.nih.gov/30773328/ – This study focuses on the diagnostic accuracy of Gallium-68 PSMA PET/CT in detecting prostate cancer. The results indicate high sensitivity and specificity for detecting prostate cancer metastases. The study supports the use of Gallium-68 PSMA PET/CT as a valuable tool in the diagnosis and management of prostate cancer.
https://ajronline.org/doi/10.2214/AJR.20.23912 – This research article evaluates the performance of Gallium-68-PSMA PET/CT in the detection of prostate cancer recurrence. The findings suggest that Gallium-68-PSMA PET/CT is a reliable imaging modality for identifying recurrent prostate cancer, which can aid in treatment planning and patient management. The study contributes to the growing body of evidence supporting the clinical utility of Gallium-68-PSMA PET/CT in prostate cancer.
https://jamanetwork.com/journals/jama/fullarticle/2793447 – This study assesses the diagnostic accuracy of prostate-specific membrane antigen (PSMA)–targeted positron emission tomography (PET) imaging with 68Ga-PSMA-11 for detecting prostate cancer metastases. The results indicate that PSMA-targeted PET imaging with 68Ga-PSMA-11 has high sensitivity and specificity for detecting prostate cancer metastases, which can improve the accuracy of staging and treatment planning. The study provides strong evidence supporting the use of PSMA-targeted PET imaging in prostate cancer management.