Omega-3 fatty acids and chemotherapy-induced toxicities: mechanisms and emerging evidence with a pediatric focus

BACKGROUND: Omega-3 fatty acids are polyunsaturated fats that are essential for proper cell structure and function. The primary types of omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is an essential fatty acid, meaning that humans and other mammals cannot produce it on their own and must obtain it from dietary sources. Research has firmly established the positive effects of omega-3 fatty acids in adults, showing benefits for cardiovascular health, brain function, mental health, inflammation, autoimmune diseases, and skin health. However, there is limited information regarding these effects in children. This narrative review evaluates the pre-clinical and clinical evidence for omega-3 polyunsaturated fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), as complementary agents in pediatric oncology. It highlights their potential antioxidant and anti-inflammatory properties in optimizing clinical outcomes, enhancing chemotherapy safety, and improving the quality of life for pediatric patients. These benefits include the suppression of reactive oxygen species (ROS) production, which helps prevent cell damage related to oxidative stress and protects healthy cells from the harmful effects of chemotherapy. Enhancing the body's ability to neutralize ROS by promoting internal antioxidant systems may improve treatment tolerance and reduce side effects. Reducing toxicity by lowering inflammation and oxidative stress will enhance the safety and effectiveness of chemotherapy. Further large-scale clinical trials in the pediatric population are necessary to confirm the potential effects of n-3 fatty acids on chemotherapy toxicity.