Pharmacogenetic-Based Interactions between Nutraceuticals and Angiogenesis Inhibitors

Abstract

Background: Angiogenesis inhibitors (AIs) have become established as an effective cancer treatment. Whereas their interactions with antineoplastic drugs have extensively been investigated, little is known of the effect of their co-administration with nutraceuticals/dietary supplements (N/DSs), which are often self-prescribed. N/DSs comprise a wide range of products such as herbs, nutrients, vitamins, minerals, and probiotics. Assessment of their interactions with cancer drugs, particularly AIs, is hampered by the difficulty of gauging the amount of active substances patients actually take. Moreover, there is no agreement on which approach should be used to determine which N/DSs are most likely to influence AI treatment efficacy. We present a comprehensive review of the metabolic routes of the major AIs and their possible interactions with N/DSs. Methods: The PubMed and Cochrane databases were searched for papers describing the metabolic routes of the main AIs and N/DSs. Results: Data from the 133 studies thus identified were used to compile a diagnostic table reporting known and expected AI-N/DS interactions based on their metabolization pathways. AIs and N/DSs sharing the cytochrome P450 pathway are at risk of negative interactions. Conclusions: Recent advances in pharmacogenetics offer exceptional opportunities to identify prognostic and predictive markers to enhance the efficacy of individualized AI treatments. The table provides a guide to genotyping patients who are due to receive AIs and is a promising tool to prevent occult AI-N/DS interactions in poor metabolizers. N/DS use by cancer patients receiving AIs is a topical problem requiring urgent attention from the scientific community.

Resveratrol in Cancer Patients: From Bench to Bedside

“…In order to unlock the therapeutic potential of resveratrol and its derivatives, further investigations are warranted aiming to enhance its pharmacokinetic profile through testing new, innovative formulations. Moreover, future clinical trials should investigate the drug interaction between anticancer agents, resveratrol and enzymes activity, particularly focusing on CYP2C9, CYP2C19 (phase I enzyme), GSTP1 and UGT (phase II enzyme) [153]. Promisingly, evaluation of individual metabolic profiles by pharmacogenetic tests should be accurate to perform a personalized therapy in cancer "frail patients" (i.e., HIV) where supplementation of resveratrol allows the reduction of antineoplastic drug dosages [154,155].…”

Biomembrane-Based Nanostructure- and Microstructure-Loaded Hydrogels for Promoting Chronic Wound Healing

“…Fibroblasts play a key role in regulating endothelium-mediated angiogenesis. 222 , 223 HBOT promotes the proliferation of fibroblasts and induces the production of the angiogenic regulators SDF-1 and VEGF, which in turn stimulate the expression of their receptors CXCR4 and VEGFR, respectively, in endothelial cells, thereby stimulating endothelial cell migration and angiogenesis. 184 However, the oxygen content of the wound decreases after treatment, and it is difficult to continuously provide sufficient oxygen via HBOT.…”

Biological Therapy with Complementary and Alternative Medicine in Innocuous Integrative Oncology: A Case of Cervical Cancer

“…Such compounds include but are not limited to the polyphenols previously described, curcumin and epigallocatechin-3-gallate from green tea [ 88 ]. The integrative medicine approach using angiogenesis inhibitors and nutraceuticals has previously been examined [ 89 ]. Although there is limited understanding of the pharmacological interactions between these two regimes, their combination for a possible synergistic action is pertinent.…”