ABSTRACT
Oncologists tend to avoid the use of supplements during chemotherapy. To understand the safety issue, a literature review was conducted to evaluate safety and possible benefits of taking curcumin during chemotherapy. Curcumin was chosen because of its wide use in the public and because of the availability of clinical trials utilizing curcumin during chemotherapy.
Curcumin is considered a “pan-assay interference compound,” creating false leads in drug discovery assays. The pharmacodynamics of curcumin presents many challenges for a therapeutic agent, including poor bioavailability and rapid metabolism and excretion. The proposed molecular targets for curcumin include inhibition of nuclear factor kappa B and inhibition of cyclooxygenase-2.
Clinical trials investigating the efficacy of curcumin treatment for cancer have been conducted in patients with colorectal cancer (CRC), pancreatic cancer, breast cancer, prostate cancer, multiple myeloma, lung cancer, and head and neck cancer. Outcomes revealed that while curcumin was not effective, it was well tolerated and safe. Recently, there have been several Phase I and Phase II trials combining curcumin with chemotherapeutic agents. Two trials investigated the effect of curcumin given concurrently with gemcitabine for advanced pancreatic cancer patients. One trial investigated the effect of curcumin given concurrently with docetaxel in advanced breast cancer patients. Another trial investigated the role of curcumin given concurrently with docetaxel and prednisone in castration-resistant prostate cancer patients.
The results again indicate the safety of curcumin, but no added benefit of adding curcumin to the chemotherapy regimen. The literature review demonstrated that curcumin is well tolerated up to 6–8g in research. While there are many promising in vivo and in vitro trials on the potential benefits of curcumin for treatment of cancer in conjunction with chemotherapy, to date there is no evidence that combining curcumin with chemotherapeutic agents is effective for treating cancer in humans. The lack of effect may be due to the target diseases that are treatment resistant such as advanced pancreatic cancer and advanced breast cancer. Also, curcumin has many difficult properties such as poor solubility and rapid metabolism. Currently, there are developments of analogues, liposomal products, and nanoparticles that may overcome the current challenges of curcumin. Future studies should utilize these evolving technologies.
Studienautor: Claudia Ferri, RD, MS, Kirsten West, ND, LAc, Karla Otero, RD, and Yoon Hang Kim, MD, MPH, FAAM
Quelle: MARY ANN LIEBERT, INC.VOL. 24 NO. 1