ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1676394
This article is part of the Research TopicIntegrating Nutrition in Cancer Therapy: Approaches to Improve Patient Outcomes and SurvivalView all 12 articles
From Trial to Real Life: Ten-Year Impact of a Nutraceutical Strategy on Duodenal Polyp Burden in Familial Adenomatous Polyposis
Provisionally accepted
Carlo Calabrese1*
Nikolas Kostantine Dussias2Laura Melotti2
Sabino Russi1
Simona Laurino1
Fabiana Crispo1Fernando Rizzello2- 1Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata, Rionero In Vulture, Italy
- 2IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Italy
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Background: Familial adenomatous polyposis (FAP) is characterized by the early development of colorectal and duodenal adenomas. Although colectomy reduces the risk of colorectal cancer, duodenal neoplasia remains a leading cause of mortality. Aims: To assess the long-term efficacy of a nutraceutical blend containing phytoestrogens and insoluble fibres (Adipol) in reducing duodenal polyp burden in FAP patients. Methods: This prospective cohort study followed 56 FAP patients for 10 years after completion of a randomised trial on Adipol. Importantly, post-trial treatment allocation was not randomised but based on patient choice. Patients freely choose one of four regimes: no therapy (Group 0), 3 months on/off (Group 1), 6 months on/off (Group 2), or continuous treatment (Group 3). Annual upper endoscopies evaluated duodenal polyp number and size. Results: At 120 months, the mean polyp count was significantly reduced in Group 3 vs Group 0 (8.2 ± 3.4 vs 25.1 ± 5.8; p<0.001). Similarly, maximum polyp size decreased more in Group 3 (3.9 ± 1.1 mm) compared to Group 0 (7.8 ± 1.9 mm; p<0.01). Groups 1– 2 showed intermediate reductions proportional to exposure. Conclusion: Continuous Adipol supplementation is associated with sustained reduction in duodenal polyp burden in FAP patients. Although the non-randomised, single-center design limits generalizability, these findings support nutritional chemoprevention as a valuable adjunct strategy in FAP. Multicenter randomised trials and biomarker studies are warranted.
Keywords: Familial Adenomatous Polyposis, Adipol, Chemoprevention, duodenal polyps, long-term follow-up
Received: 30 Jul 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Calabrese, Dussias, Melotti, Russi, Laurino, Crispo and Rizzello. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Carlo Calabrese, carlo.calabrese2@unibo.it
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