Palliative treatment for advanced biliary adenocarcinomas with combination dimethyl sulfoxide-sodium bicarbonate infusion and S-adenosyl-L-methionine

J Pain Palliat Care Pharmacother. 2014 Sep;28(3):206-11. doi: 10.3109/15360288.2014.938882. Epub 2014 Aug 7.


Adenocarcinoma of the gallbladder and cholangiocarcinoma account for 4% and 3%, respectively, of all gastrointestinal cancers. Advanced biliary tract carcinoma has a very poor prognosis with all current available modalities of treatment. In this pilot open-label study, the authors investigated the efficacy and safety of a combination of dimethyl sulfoxide-sodium bicarbonate (DMSO-SB) infusion and S-adenosyl-L-methionine (ademetionine) oral supplementation as palliative pharmacotherapy in nine patients with advanced nonresectable biliary tract carcinomas (ABTCs). Patients with evidence of biliary obstruction with a total serum bilirubin ≤300 μmol/L were allowed to join the study. The results of this 6-month study and follow-up of all nine patients with ABTC indicated that the investigated combination treatment improved pain control, blood biochemical parameters, and quality of life for the patients. Moreover, this method of treatment has led to a 6-month progression-free survival for all investigated patients. The treatment was well tolerated for all patients without major adverse reactions. Given that ABTC is a highly fatal malignancy with poor response to chemotherapy and targeted drugs, the authors consider that the combination of DMSO-SB and ademetionine deserves further research and application as a palliative care and survival-enhancing treatment for this group of patients.

Keywords: adenosylmethionine; biliary tract carcinoma; cholangiocarcinoma; dimethyl sulfoxide; sodium bicarbonate.

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Administration, Oral
  • Aged
  • Biliary Tract Neoplasms / drug therapy*
  • Dimethyl Sulfoxide / administration & dosage
  • Dimethyl Sulfoxide / therapeutic use*
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Pain Management / methods
  • Palliative Care / methods*
  • Quality of Life
  • S-Adenosylmethionine / administration & dosage
  • S-Adenosylmethionine / therapeutic use*
  • Sodium Bicarbonate / administration & dosage
  • Sodium Bicarbonate / therapeutic use*


  • S-Adenosylmethionine
  • Sodium Bicarbonate
  • Dimethyl Sulfoxide