Toxicology, Safety and Herb–drug Interactions in Cancer Therapy

摘要: Cancer patients always seek alternative approaches without advising the oncologists about their use of herbal/dietary supplements. There are increased reports on interaction herbal medicines and anticancer drugs that is becoming a safety concern. For example, clinical study in cancer reported treatment Hypericum perforatum (St John’s wort) at 900 mg/day orally for 18 days decreased plasma levels active metabolite irinotecan, SN-38, by 42%. In healthy subjects, 2 weeks with St wort significantly systemic exposure imatinib 32%. women advanced breast cancer, coadministration garlic supplement reduced clearance docetaxol 23.1–35.1%, although difference did not achieve statistical significance. A recent trial resected or colon has revealed Chinese alleviate chemotherapy-induced haematological toxicity, but drug-induced nausea. Most undergo Phase I and/or II metabolism substrates P-glycoprotein, resistance protein, multidrug associated proteins, other transporters. Induction inhibition these enzymes transporters considered an important mechanism herb–anticancer drug interactions. Timely identification involved victim to remind both possible concerns arising from combined herbs any drugs. Monitoring concentrations concurrently administered observing signs toxicity necessary when remedies used concurrently.