Abstract
More than half of Thai patients with cancer take herbal preparations while receiving anticancer therapy. There is no systematic or scoping review on interactions between anticancer drugs and Thai herbs, although several research articles have that Thai herbs inhibit cytochrome P450 (CYP) or efflux transporter. Therefore, we gathered and integrated information related to the interactions between anticancer drugs and Thai herbs. Fifty-two anticancer drugs from the 2020 Thailand National List of Essential Medicines and 75 herbs from the 2020 Thai Herbal Pharmacopoeia were selected to determine potential anticancer drug–herb interactions. The pharmacological profiles of the selected anticancer drugs were reviewed and matched with the herbal pharmacological activities to determine possible interactions. A large number of potential anticancer drug–herb interactions were found; the majority involved CYP inhibition. Efflux transporter inhibition and enzyme induction were also found, which could interfere with the pharmacokinetic profiles of anticancer drugs. However, there is limited knowledge on the pharmacodynamic interactions between anticancer drugs and Thai herbs. Therefore, further research is warranted. Information regarding interactions between anticancer drugs and Thai herbs should provide as a useful resource to healthcare professionals in daily practice. It could enable the prediction of possible anticancer drug–herb interactions and could be used to optimize cancer therapy outcomes.
Highlights
According to the World Health Organization, cancer was one of the top 10 causes of worldwide death in 2019 [1]
Since patients with cancer often take herbs to prevent and relieve the symptoms and adverse effects from anticancer drugs [9], healthcare professionals should be aware and must be vigilant against anticancer drug–herb interaction (DHI) problems arising from the use of herbs as an alternative or supportive treatment [10,11]
Several anticancer drugs are excreted via the renal tubules and/or the hepatobiliary system by transmembrane transporters, especially P-glycoprotein
Summary
According to the World Health Organization, cancer was one of the top 10 causes of worldwide death in 2019 [1]. Cancer is a group of diseases caused by an abnormality in cell proliferation and differentiation, which results in an invasion into organs, leading to metastasis and death [3]. Patients with cancer are treated with many types of chemotherapeutic agents, which predispose them to high incidences of adverse drug reactions and put them at high risk of drug–drug interactions, resulting in sub-therapeutic effects or increased unwanted toxicities that could potentiate the negative outcomes of Pharmaceuticals 2022, 15, 146. There are reports on herbal medicines used by patients with cancer as an alternative or supportive treatment. Since patients with cancer often take herbs to prevent and relieve the symptoms and adverse effects from anticancer drugs [9], healthcare professionals should be aware and must be vigilant against anticancer drug–herb interaction (DHI) problems arising from the use of herbs as an alternative or supportive treatment [10,11]
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