Abstract

Head and neck squamous cell carcinoma (HNSCC) is associated with low survival, and the current aggressive therapies result in high morbidity. Nutraceuticals are dietary compounds with few side effects. However, limited antitumor efficacy has restricted their application for cancer therapy. Here, we examine combining nutraceuticals, establishing a combination therapy that is more potent than any singular component, and delineate the mechanism of action. Three formulations were tested: GZ17-S (combined plant extracts from Arum palaestinum, Peganum harmala and Curcuma longa); GZ17-05.00 (16 synthetic components of GZ17-S); and GZ17-6.02 (3 synthetic components of GZ17S; curcumin, harmine and isovanillin). We tested the formulations on HNSCC proliferation, migration, invasion, angiogenesis, macrophage viability and infiltration into the tumor and tumor apoptosis. GZ17-6.02, the most effective formulation, significantly reduced in vitro assessments of HNSCC progression. When combined with cisplatin, GZ17-6.02 enhanced anti-proliferative effects. Molecular signaling cascades inhibited by GZ17-6.02 include EGFR, ERK1/2, and AKT, and molecular docking analyses demonstrate GZ17-6.02 components bind at distinct binding sites. GZ17-6.02 significantly inhibited growth of HNSCC cell line, patient-derived xenografts, and murine syngeneic tumors in vivo (P < 0.001). We demonstrate GZ17-6.02 as a highly effective plant extract combination and pave the way for future clinical application in HNSCC.

Highlights

  • IntroductionOverall survival of head and neck squamous cell carcinoma (HNSCC) has marginally improved over the past 30 years[1]

  • Despite advances in therapy, overall survival of head and neck squamous cell carcinoma (HNSCC) has marginally improved over the past 30 years[1]

  • To determine the dose response to the formulations, varying concentrations of GZ17-formulations were tested on HNSCC cell lines (0, 0.78125, 1.5625, 3.125, 6.25, 12.5, 25, 50 ug/mL)

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Summary

Introduction

Overall survival of head and neck squamous cell carcinoma (HNSCC) has marginally improved over the past 30 years[1]. One-third to one-half of survivors develop second primary tumors With these dismal outcomes, there is great need for improved HNSCC therapies. HNSCC nutraceutical clinical trials include: vitamin A derivatives[7], curcumin[8], green tea extract[9], soybean extract[10], and lycopene[11]. These are limited by studying prevention rather than treatment, and have had little efficacy and adoption into practice. Arum palaestinum is widely cultivated in Palestine, and has been used in the treatment of cancer in Palestine for many years[20]. Little has been done to characterize Arum palaestinum’s mechanism of action

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