Safety of herbal medicine use during chemotherapy in patients with ovarian cancer: a “bedside-to-bench” approach

Medical Oncology - 2017
Eran Ben-Arye1,2, Ofer Lavie3, Noah Samuels4,1, Hazem Khamaisie5, Elad Schiff6, Orit Gressel Raz1, Jamal Mahajna5,7
1Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel
2Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
3Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel
4Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel
5Cancer Drug Discovery Program, Galilee Technology Center (Migal), Kiryat Shmona, Israel
6Departments of Internal Medicine and Integrative Surgery Service, Bnai Zion Hospital, Haifa, Israel
7Nutritional Sciences Department, Tel Hai College, Kiryat Shmona, Israel

Tóm tắt

In this study, we explored herbal supplements used by patients during chemotherapy and test for herb-drug interactions and response of cancer cells to treatment. Patients with gynecological cancer referred to a complementary and integrative medicine (CIM) service were asked about their use of herbal medicine during chemotherapy. The leading five clinically relevant herbs selected for cytotoxicity analysis included the following: wheatgrass (Triticum aestivum), European mistletoe (Viscum album), ginger (Zingiber officinale), Ephedra (Ephedra campylopoda), and Oriental mistletoe (Viscum cruciatum). Cytotoxicity was examined using XTT assays in cisplatin-sensitive and resistant ovarian cancer cell lines (A2780, A2780CisR), and non-cancer kidney cells (HEK-293). The effect of the selected herbs on carboplatin and paclitaxel cytotoxicity was tested as well. Pro-apoptotic effects were tested using Poly(ADP-ribose) polymerase (PARP) cleavage. Of 98 patients referred to the CIM service, 42 (42.9%) reported using/intending to use herbal products during chemotherapy. European mistletoe and ginger exhibited significant anti-cancer activity in cisplatin-sensitive and resistant ovarian cells. Wheatgrass and ephedra reduced cytotoxicity of carboplatin on cisplatin-sensitive ovarian cancer cells, while ginger, European and Oriental mistletoe increased chemosensitivity in both cancer cell lines. Wheatgrass, European mistletoe, and ginger increased sensitivity to cisplatin-resistant cells treated with carboplatin and paclitaxel. No effect was observed with the addition of any of the herbs on non-cancerous embryonic kidney cells (HEK-293). Herbal medicine use by patients with ovarian cancer may influence anti-cancer activity of chemotherapy. Integrative physicians can provide “bedside-to-bench” guidance on the safety of these products.

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Tài liệu tham khảo

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