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. 2022 Oct 23;14(21):5203.
doi: 10.3390/cancers14215203.

Evaluation of Concomitant Use of Anticancer Drugs and Herbal Products: From Interactions to Synergic Activity

Massimiliano Berretta  1   2 , Lissandra Dal Lago  3 , Mattia Tinazzi  4 , Andrea Ronchi  5 , Gaspare La Rocca  6 , Liliana Montella  7 , Raffaele Di Francia  8 , Bianca Arianna Facchini  9 , Alessia Bignucolo  2   10 , Monica Montopoli  2   4
Affiliations

Evaluation of Concomitant Use of Anticancer Drugs and Herbal Products: From Interactions to Synergic Activity

Massimiliano Berretta et al. Cancers (Basel). .

Abstract

CAM is used by about 40% of cancer patients in Western Countries, with peaks of 80% for breast cancer patients. Cancer patients use CAM to boost immune function, to control cancer symptoms and treatment-related side effects, and to improve health-related quality of life (HR-QoL) and survival. Unfortunately, self-prescription of natural remedies in cancer patients can lead to unexpected toxicities and can reduce the effectiveness of cancer therapy. Although CAM usually refers to all the "natural or organic" products/methods that are generally considered less toxic, there are concerns about drug interactions, especially in patients participating in clinical trials with experimental agents. Despite the claims of the promising and potential benefits made by prescribers, many CAMs lack clear scientific evidence of their safety and efficacy. Given the widespread use of CAM-both clearly declared and overt-in this review, we focused on the most important known data on the risk of interactions between biologics and oncology drugs with the goal of opening up CAM in accordance with the meaning of integrative medicine.

Keywords: alternative; cancer; chemotherapy; complementary; interactions; medicine; synergism.

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Conflict of interest statement

The Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CAM categories.
Figure 2
Figure 2
Possible mechanisms of drug−herb interactions, leading to toxicity development or lack of drug efficacy.
Figure 3
Figure 3
Herbs/nutraceuticals commonly used as CAMs that induce and/or inhibit different CYP subfamilies.
Figure 4
Figure 4
Suitable pharmacovigilance activity via DDI checker programs in cancer patients’ journey.
See this image and copyright information in PMC

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