Safety and pharmacokinetic trial of docetaxel plus an Astragalus-based herbal formula for non-small cell lung cancer patients

Cassileth, Barrie R.; Rizvi, Naiyer A.; Deng, Gary; Yeung, K. Simon; Vickers, Andrew J.; Guillén, S. Martín; Woo, Derek; Coleton, Marci; Kris, Mark G.

doi:10.1007/s00280-009-1003-z

Cited by 60 publications

(43 citation statements)

References 7 publications

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“…In patients with non-small cell lung cancer (NSCLC, n = 21), Astragalus-based herbal formula (Jinfukang) had no significant impact on the pharmacokinetics of docetaxel [23]. Median time to progression or withdrawal from treatment was 7 weeks.…”

Section: Astragalusmentioning

confidence: 99%

Herbal Interactions with Anticancer Drugs: Mechanistic and Clinical Considerations

Yang

Liu

et al. 2010

CMC

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A large number of herbal remedies (e.g. garlic, mistletoe, Essiac, Lingzhi, and astragalus) are used by cancer patients for treating the cancer and/or reducing the toxicities of chemotherapeutic drugs. Some herbal medicines have shown potentially beneficial effects on cancer progression and may ameliorate chemotherapy-induced toxicities. However, there is no or weak scientific basis for the clinical use of these herbal medicines in cancer management and almost none of these plant medicines have been tested in rigorous clinical trials. There are increased reports on the interaction of herbal medicines and anticancer drugs that is becoming a safety concern. For example, a clinical study in cancer patients reported that treatment of St John's wort at 900 mg/day orally for 18 days decreased the plasma levels of the active metabolite of irinotecan, SN-38, by 42%. In healthy subjects, 2 weeks of treatment with St John's wort at 900 mg/day significantly decreased the systemic exposure of imatinib by 32%. In women with advanced breast cancer, coadministration of garlic supplement reduced the clearance of docetaxol by 23.1-35.1%, although the difference did not achieve statistical significance. Most anticancer drugs undergo Phase I and/or II metabolism and are substrates of P-glycoprotein, breast cancer resistance protein, multidrug resistance associated proteins, and/or other transporters. Induction and inhibition of these enzymes and transporters is considered an important mechanism for herb-anticancer drug interactions. Further studies are warranted to investigate potentially harmful herbal interactions with anticancer drugs in patients.

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Section: Astragalusmentioning

confidence: 99%

Herbal Interactions with Anticancer Drugs: Mechanistic and Clinical Considerations

Yang

Liu

et al. 2010

CMC

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“…However, because the synergistic mechanism and the true positive interaction have not been identified, it is possible that herbal medicine could produce detrimental drug-herb interactions when combined with chemotherapy. Further research regarding the interaction of aRVS with a variety of chemotherapy regimens is warranted [37][38][39].…”

Section: Clinicopathologic Characteristics Of Patientsmentioning

confidence: 99%

Efficacy and Safety of <i>Rhus verniciflua</i> Stokes Extracts in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer

Cheon¹,

Kim²,

Kim³

et al. 2011

Forsch Komplementmed

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Background: Systemic treatments for advanced non-small cell lung cancer (NSCLC) have modest survival benefits but high toxicity. Rhus verniciflua Stokes (RVS), the lacquer tree, is an ancient traditional medicine being used for the treatment of cancer. We investigated the efficacy and safety of allergen-removed RVS extract (aRVS) for the prolongation of survival in NSCLC after the failure of first-line or secondline chemotherapy. Patients and Methods: We reviewed the medical records of 40 patients who were treated with aRVS for previously treated, advanced NSCLC at the M×µ Integrative Cancer Center, Korea, between June 2006 and June 2009. The primary objective of this study was to assess overall survival. Secondary objectives included assessments of disease control rates, progression-free survival, and the safety of aRVS treatment. Results: The median survival time was 8.4 months with a 1-year survival of 40%. The disease control rate was 63.6%, and the median progression-free survival interval was 3.9 months. Patients who had better performance status and adenocarcinoma experienced more favorable outcomes in terms of overall survival. in aRVS treatment were negligible, with the most common drug-related adverse events being mild epigastric pain and itching skin. Hematologic toxicity was absent. Conclusions: Survival data and favorable levels of tolerability suggest the potential of aRVS treatment in previously treated patients with advanced NSCLC. Treatment with aRVS might be a viable alternative in patients for whom chemotherapy is not feasible, or who refuse chemotherapy.

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“…mongholica are widely used as Radix Astragali in Asian countries. It has been shown that this herb possesses pharmacological activities, such as immunomodulation, antitumor, antiviral, anti-aging, and it can reduce blood glucose levels [20][21][22][23][24][25][26][27][28][29]. Because of its high value and market demand, and aside from the two species recorded in the Chinese Pharmacopoeia, about 23 other species from the genera Astragalus, Oxytropis, Hedysarum, and Glycyrrhiza have been abused as adulterants in folk markets and the TCM industry [30][31][32][33][34].…”

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confidence: 99%

DNA barcoding provides distinction between Radix Astragali and its adulterants

Guo

Wang

Yang

et al. 2010

Sci. China Life Sci.

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Based on variable nuclear and/or organellar DNA sequences among vastly divergent species as well as morphologically indistinguishable species, DNA barcoding is widely applicable in species identification, biodiversity studies, forensic analyses, and authentication of medicinal plants. The roots of Astragalus membranaceus and A. membranaceus var. mongholica are commonly used as Radix Astragali in several Asian countries, including China, Japan, and Korea. However, in addition to the two species recorded in the Chinese Pharmacopoeia, there are twenty-three species from different genera including Astragalus, Oxytropis, Hedysarum, and Glycyrrhiza, which have been used as adulterants not only in trading markets but also by the herbal medicine industry. Therefore, a simple, reliable, and accurate classification method is important for distinguishing authentic Radix Astragali from its adulterants. In this study, we acquired data for 37 samples from four related genera within the family Fabaceae. Then we compared four candidate DNA barcoding markers using ITS, matK, rbcL, and coxI sequences from nuclear, chloroplast, and mitochondrial genomes, all commonly used for plants to identify genetic variations among genera, intraspecies, and interspecies. We observed higher divergences among genera and interspecies for ITS, which have the average Kimura 2-parameter distances of 4.5% and 14.1%, respectively, whereas matK was found to have sufficient divergence at the intraspecific level. Moreover, two indels detected in the matK sequence are useful for PCR studies in distinguishing Radix Astragali from its adulterants. This study suggests that the combined barcoding regions of ITS and matK are superior barcodes for Radix Astragali and further studies should focus on evaluating the applicability and accuracy of such combined markers for a wide range of traditional Chinese herbs.

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Safety and pharmacokinetic trial of docetaxel plus an Astragalus-based herbal formula for non-small cell lung cancer patients

Cited by 60 publications

References 7 publications

Herbal Interactions with Anticancer Drugs: Mechanistic and Clinical Considerations

Herbal Interactions with Anticancer Drugs: Mechanistic and Clinical Considerations

Efficacy and Safety of <i>Rhus verniciflua</i> Stokes Extracts in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer

DNA barcoding provides distinction between Radix Astragali and its adulterants

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