Abstract
BackgroundGiven the importance of complementary and alternative medicine (CAM) to cancer patients, there is an increasing need to learn more about possible interactions between CAM and anticancer drugs. Mistletoe (Viscum album L.) belongs to the medicinal herbs that are used as supportive care during chemotherapy. In the in vitro study presented here the effect of standardized mistletoe preparations on the cytostatic and cytotoxic activity of several common conventional chemotherapeutic drugs was investigated using different cancer cell lines.MethodsHuman breast carcinoma cell lines HCC1937 and HCC1143 were treated with doxorubicin hydrochloride, pancreas adenocarcinoma cell line PA-TU-8902 with gemcitabine hydrochloride, prostate carcinoma cell line DU145 with docetaxel and mitoxantrone hydrochloride and lung carcinoma cell line NCI-H460 was treated with docetaxel and cisplatin. Each dose of the respective chemotherapeutic drug was combined with Viscum album extract (VAE) in clinically relevant concentrations and proliferation and apoptosis were measured.ResultsVAE did not inhibit chemotherapy induced cytostasis and cytotoxicity in any of our experimental settings. At higher concentrations VAE showed an additive inhibitory effect.ConclusionsOur in vitro results suggest that no risk of safety by herb drug interactions has to be expected from the exposition of cancer cells to chemotherapeutic drugs and VAE simultaneously.
Highlights
Given the importance of complementary and alternative medicine (CAM) to cancer patients, there is an increasing need to learn more about possible interactions between CAM and anticancer drugs
Effects of Viscum album extract (VAE) on proliferation and apoptosis of cancer cell lines The growth kinetic analysis of five cancer cell lines revealed a dose dependent anti-proliferative effect of VAE at concentrations ≥10 μg/ml except for the pancreas carcinoma cell line PA-TU-8902 and the lung carcinoma cell line NCI-H460, where a proliferation inhibition could only be detected with 100 μg/ml (p < 0.05)
Effects of a combined application of VAE and chemotherapeutic drugs on proliferation and apoptosis/ necrosis in cancer cells Figure 2 presents the mean values of proliferation, early apoptosis and late apoptosis/necrosis of the breast carcinoma cell lines HCC1143 and HCC1937 treated with different concentrations of doxorubicin in combination with different concentrations of VAE-M
Summary
Given the importance of complementary and alternative medicine (CAM) to cancer patients, there is an increasing need to learn more about possible interactions between CAM and anticancer drugs. In the in vitro study presented here the effect of standardized mistletoe preparations on the cytostatic and cytotoxic activity of several common conventional chemotherapeutic drugs was investigated using different cancer cell lines. Mistletoe (Viscum album) preparations contain active components like mistletoe lectins and viscotoxins and are reported to show anti-tumoral properties by causing cell cycle delay or arrest and induction of apoptosis [4,5,6,7], affecting tumor angiogenesis [8,9] and exerting immune-potentiating activities that may enhance the host defense system against tumors [10,11,12,13]. In early stage breast cancer patients the frequency of relapse or metastasis within 5 years was not influenced by additional mistletoe therapy [19]
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