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

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Drug-herb interaction

Gynecologic oncology

Integrative medicine

Safety

Journal Title medical oncology (northwood, london, england)
Publication Year Start




PMID- 28238155
OWN - NLM
STAT- In-Process
DA  - 20170226
LR  - 20170226
IS  - 1559-131X (Electronic)
IS  - 1357-0560 (Linking)
VI  - 34
IP  - 4
DP  - 2017 Apr
TI  - Safety of herbal medicine use during chemotherapy in patients with ovarian
      cancer: a "bedside-to-bench" approach.
PG  - 54
LID - 10.1007/s12032-017-0910-9 [doi]
AB  - 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.
FAU - Ben-Arye, Eran
AU  - Ben-Arye E
AD  - Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health
      Services, 35 Rothschild St., Haifa and Western Galilee District, Israel.
      [email protected]
AD  - Complementary and Traditional Medicine Unit, Department of Family Medicine,
      Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
      [email protected]
FAU - Lavie, Ofer
AU  - Lavie O
AD  - Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Gynecologic
      Oncology Service, Carmel Medical Center, Haifa, Israel.
FAU - Samuels, Noah
AU  - Samuels N
AD  - Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health
      Services, 35 Rothschild St., Haifa and Western Galilee District, Israel.
AD  - Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center,
      Tel Hashomer, Israel.
FAU - Khamaisie, Hazem
AU  - Khamaisie H
AD  - Cancer Drug Discovery Program, Galilee Technology Center (Migal), Kiryat Shmona, 
      Israel.
FAU - Schiff, Elad
AU  - Schiff E
AD  - Departments of Internal Medicine and Integrative Surgery Service, Bnai Zion
      Hospital, Haifa, Israel.
FAU - Raz, Orit Gressel
AU  - Raz OG
AD  - Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health
      Services, 35 Rothschild St., Haifa and Western Galilee District, Israel.
FAU - Mahajna, Jamal
AU  - Mahajna J
AD  - Cancer Drug Discovery Program, Galilee Technology Center (Migal), Kiryat Shmona, 
      Israel.
AD  - Nutritional Sciences Department, Tel Hai College, Kiryat Shmona, Israel.
LA  - eng
PT  - Journal Article
DEP - 20170225
PL  - United States
TA  - Med Oncol
JT  - Medical oncology (Northwood, London, England)
JID - 9435512
OTO - NOTNLM
OT  - Drug-herb interaction
OT  - Gynecologic oncology
OT  - Integrative medicine
OT  - Safety
EDAT- 2017/02/27 06:00
MHDA- 2017/02/27 06:00
CRDT- 2017/02/27 06:00
PHST- 2017/01/24 [received]
PHST- 2017/02/18 [accepted]
AID - 10.1007/s12032-017-0910-9 [doi]
AID - 10.1007/s12032-017-0910-9 [pii]
PST - ppublish
SO  - Med Oncol. 2017 Apr;34(4):54. doi: 10.1007/s12032-017-0910-9. Epub 2017 Feb 25.

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