Abstract
Angelica sinensis (AS, Danggui) has long been regarded to stimulate breast cancer growth; hence, the use of AS in breast cancer patients remains a major concern for both patients and practitioners. Since safety studies of herbs would be unethical to carry out in patients, the present study aimed to investigate the potential unsafe effects of AS in a systematic pre-clinical approach. Human breast cancer cells, breast orthotopic tumor-bearing mouse models, as well as primary breast cancer cells from patients’ tumors were used to evaluate the effect of AS hot water extract on the progression of breast tumors and/or growth of breast cancer cells. We showed that AS is not that stimulatory in breast cancer both in vitro and in vivo, though AS should still be used with caution in estrogen receptor-positive breast cancer patients. This novel approach of applying breast cancer cell lines, xenograft, and syngeneic tumors models, as well as primary breast cancer cells from patients’ tumors in Chinese medicines safety evaluation was proven feasible. Our finding is important information for patients, Chinese medicine practitioners, and clinicians on the safety use of AS in breast cancer, which will affect future clinical practice.
Highlights
Breast cancer is the most frequently diagnosed cancer among women worldwide with an estimated 1.67 million new cancer cases diagnosed in 2012 (25% of all cancers) (Ferlay et al, 2018)
The Angelica sinensis (AS) herbal sample with 0.055% (w/w) ferulic acid, which was higher than the minimum amount of ferulic acid 0.05% (w/w) in dried raw herb according to Chinese Pharmacopoeia, was used for preparation of aqueous extract for the present study
A systematic pre-clinical research platform has been established for Chinese herbal medicine (CHM) safety evaluation in cancer management
Summary
Breast cancer is the most frequently diagnosed cancer among women worldwide with an estimated 1.67 million new cancer cases diagnosed in 2012 (25% of all cancers) (Ferlay et al, 2018). In Hong Kong, the incidence rate of breast cancer is the highest in female, accounting for 26.1% of total cancer. The use of complementary and alternative medicine (CAM) as an adjuvant to cancer treatment is more frequent among breast cancer patients all over the world (DiGianni et al, 2002; Boon et al, 2007; Davis et al, 2010; Wong et al, 2014; Dietz et al, 2016). A survey on CAM use in the Scottish breast cancer population showed that 33.1% of respondents reported using CAM, including dietary supplements (McLay et al, 2012). Chinese herbal medicine (CHM) is a popular form of CAM among Chinese population (Lam et al, 2009; Wong et al, 2010; Lin and Chiu, 2011; Liu et al, 2012; Fan et al, 2014)
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