A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer

Pantuck, Allan J.; Pettaway, Curtis A.; Dreicer, Robert; Corman, John M.; Katz, Aaron E.; Ho, Ayy; Aronson, William J.; Clark, William R.; Simmons, Glennon W.; Heber, David

doi:10.1038/pcan.2015.32

Cited by 55 publications

(51 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, practitioners should be aware of them as patients may not always thoroughly disclose herbal products. After a phase II single arm trial of pomegranate juice, it showed significant (6 months) improvement in PSADT from baseline [55]; Paller and colleagues [56••] designed a phase II trial which was a double-blind placebo-controlled multi-institutional study that recruited 183 patients. The median PSADT increased from 11.1 months at baseline to 15.6 months in the placebo group compared with an increase from 12.9 months at baseline to 14.5 months in the pomegranate extract group (p = 0.13).…”

Section: Natural Productsmentioning

confidence: 99%

Management Options for Biochemically Recurrent Prostate Cancer

Fakhrejahani

Madan

Dahut

2017

Curr. Treat. Options in Oncol.

View full text Add to dashboard Cite

Prostate cancer is the most common solid tumor malignancy in men worldwide. Treatment with surgery and radiation can be curative in organ-confined disease. Unfortunately, about one third of men develop biochemically recurrent disease based only on rising prostate-specific antigen (PSA) in the absence of visible disease on conventional imaging. For these patients with biochemical recurrent prostate cancer, there is no uniform guideline for subsequent management. Based on available data, it seems prudent that biochemical recurrent prostate cancer should initially be evaluated for salvage radiation or prostatectomy, with curative intent. In selected cases, high-intensity focused ultrasound and cryotherapy may be considered in patients that meet very narrow criteria as defined by non-randomized trials. If salvage options are not practical or unsuccessful, androgen deprivation therapy (ADT) is a standard option for disease control. While some patients prefer ADT to manage the disease immediately, others defer treatment because of the associated toxicity. In the absence of definitive randomized data, patients may be followed using PSA doubling time as a trigger to initiate ADT. Based on retrospective data, a PSA doubling time of less than 3-6 months has been associated with near-term development of metastasis and thus could be used signal to initiate ADT. Once treatment is begun, patients and their providers can choose between an intermittent and continuous ADT strategy. The intermittent approach may limit side effects but in patients with metastatic disease studies could not exclude a 20% greater risk of death. In men with biochemical recurrence, large studies have shown that intermittent therapy is non-inferior to continuous therapy, thus making this a reasonable option. Since biochemically recurrent prostate cancer is defined by technological limitations of radiographic detection, as new imaging (i.e., PSMA) strategies are developed, it may alter how the disease is monitored and perhaps managed. Furthermore, patients have no symptoms related to their disease and thus many prefer options that minimize toxicity. For this reason, herbal agents and immunotherapy are under investigation as potential alternatives to ADT and its accompanying side effects. New therapeutic options combined with improved imaging to evaluate the disease may markedly change how biochemically recurrent prostate cancer is managed in the future.

show abstract

Section: Natural Productsmentioning

confidence: 99%

Management Options for Biochemically Recurrent Prostate Cancer

Fakhrejahani

Madan

Dahut

2017

Curr. Treat. Options in Oncol.

View full text Add to dashboard Cite

show abstract

“…treatment of patients suffering from prostate cancer [131,[133][134][135]. Pantuck et al, first reported on clinical trials in prostate cancer patients where elongation in the PSA doubling time (PSADT) was observed after treatment with PJ [133].…”

Section: Clinicopathological Studies Of Pomegranate On Cancermentioning

confidence: 99%

Possible use of Punica granatum (Pomegranate) in cancer therapy

Khwairakpam

Bordoloi

Thakur

et al. 2018

Pharmacological Research

130

View full text Add to dashboard Cite

The intake of fruits has proven to reduce the risk and incidence of cancer worldwide and plays a crucial role in cancer prevention. Pomegranate (Punica granatum), which belongs to the Punicaceae family, is one such plant that contains beneficial nutrients as well as many bioactive components and important phytochemicals that can be attributed to cancer-related therapeutic purposes. Pomegranate possesses antioxidant, anti-inflammatory, anti-proliferative, anti-angiogenic, anti-invasive, and anti-metastatic properties, and induces apoptosis. It also down-regulates various signaling pathways such as NF-κB, PI3K/AKT/mTOR, and Wnt, and down-regulates the expression of genes that are responsible in cancer development, such as anti-apoptotic genes, MMPs, VEGF, c-met, cyclins, Cdks, and pro-inflammatory cytokines. Therefore, inclusion of the fruit in one's diet would assist in a healthy life protected from cancer and also act as an effective chemotherapeutic with no toxic side effects.

show abstract

“…However, this study also suffered from the same limitation since it did not include a placebo-control arm that was a drawback of the previous study. Strikingly, a recent multi-institutional randomized placebo-controlled trial of pomegranate extract showed no significant prolongation of PSADT in PCA patients with rising PSA after primary therapy [102]. …”

Section: Whole Vs Isolated Compound Entitiesmentioning

confidence: 99%

Food-based natural products for cancer management: Is the whole greater than the sum of the parts?

Hussain

Kumar

Ghosh

2016

Seminars in Cancer Biology

View full text Add to dashboard Cite

The rise in cancer incidence and mortality in developing countries together with the human and financial cost of current cancer therapy mandates a closer look at alternative ways to overcome this burgeoning global healthcare problem. Epidemiological evidence for the association between cancer and diet and the long latency of most cancer progression have led to active exploration of whole and isolated natural chemicals from different naturally occurring substances in various preclinical and clinical settings. In general the lack of systemic toxicities of most ‘whole’ and ‘isolated’ natural compounds, their potential to reduce toxic doses and potential to delay the development of drug-resistance makes them promising candidates for cancer management. This review article examines the suggested molecular mechanisms affected by these substances focusing to a large extent on prostate cancer and deliberates on the disparate results obtained from cell culture, preclinical and clinical studies in an effort to highlight the use of whole extracts and isolated constituents for intervention. As such these studies underscore the importance of factors such as treatment duration, bioavailability, route of administration, selection criteria, standardized formulation and clinical end points in clinical trial design with both entities. Overall lack of parallel comparison studies between the whole natural products and their isolated compounds limits decisive conclusions regarding the superior utility of one over the other. We suggest the critical need for rigorous comparative research to identify which one of the two or both entities from nature would be best qualified to take on the mantle of cancer management.

show abstract

A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer

Cited by 55 publications

References 38 publications

Management Options for Biochemically Recurrent Prostate Cancer

Management Options for Biochemically Recurrent Prostate Cancer

Possible use of Punica granatum (Pomegranate) in cancer therapy

Food-based natural products for cancer management: Is the whole greater than the sum of the parts?

Contact Info

Product

Resources

About