Abstract. Gemcitabine is a first line cancer drug widely used for the treatment of pancreatic cancer. However, its therapeutic efficiency is significantly limited by resistance of pancreatic cancer cells to this and other chemotherapeutic drugs. We have investigated the cytotoxic effect of Turmeric Force™ (TF), a supercritical and hydroethanolic extract of turmeric, alone and in combination with gemcitabine in two pancreatic carcinoma cell lines (BxPC3 and Panc-1). TF is highly cytotoxic to BxPC3 and Panc-1 cell lines with IC 50 values of 1.0 and 1.22 μg/ml, respectively with superior cytotoxicity than curcumin. Gemcitabine IC 50 value for both of these cell line is 0.03 μg/ml; however, 30-48% of the pancreatic cancer cells are resistant to gemcitabine even at concentrations >100 μg/ml. In comparison, TF induced cell death in 96% of the cells at 50 μg/ml. The combination of gemcitabine and TF was synergistic with IC 90 levels achieved in both pancreatic cancer cell lines at lower concentrations. CalcuSyn analysis of cytotoxicity data showed that the Gemcitabine + Turmeric Force combination has strong synergism with combination index (CI) values of 0.050 and 0.183 in BxPC3 and Panc-1 lines, respectively at IC 50 level. This synergistic effect is due to the increased inhibitory effect of the combination on nuclear factor-κ B activity and signal transducer and activator of transcription factor 3 expression as compared to the single agent.
IntroductionPancreatic carcinoma is among the most aggressive forms of human cancer with a very high mortality rate. It represents the fourth leading cause of cancer death in United States with an annual mortality of 32,000. With a 5-year survival rate of only 3% and a median survival of <6 months, diagnosis of pancreatic adenocarcinoma carries one of the poorest prognoses of any form of cancer (1,2). Consequently, the management and treatment of this relatively common form of cancer is considered to be a major medical challenge for the 21st century. Pancreatic cancers are difficult to detect and diagnose because in the early stages of the disease, patients are generally asymptomatic or demonstrate signs and symptoms that mimic other more common illnesses (3). Consequently, at the time of diagnosis the disease has typically metastasized making treatment of pancreatic cancer extremely difficult. Chemotherapy alone or as adjuvant to surgery or radiation has not significantly contributed to the cure or prolongation of survival in pancreatic cancer patients (4). Among the recently approved drugs, gemcitabine (GEM) represents an important advance and is the first chemotherapy agent approved on the basis of clinical response instead of the traditional increase in survival time. Therefore, effective therapeutic drugs or drug combinations to improve survival time are yet to be identified.Recent studies indicate that novel strategies for sensitizing pancreatic cancer cells with natural dietary chemopreventive agents would be beneficial for overcoming intrinsic tumor cell resistance (5-8). ...