The survey of antitumor effects of bromelain on neoplastic breast cells: A systematic review

Abstract

Background: Breast cancer is one of the most prevalent cancers in women worldwide. Considering the side effects of chemotherapy treatments, we investigated the anticancer effects and mechanisms of bromelain (Br) on breast cancer cells in this systematic review. Methods: The PRISMA recommendations were followed to design this systematic review. Web of Science, PubMed, Cochrane Library, and Scopus were high-coverage databases used for searching. After considering the inclusion and exclusion criteria for the study, 18 articles were included. The desired information was gathered, entered into an Excel file, and the study outcomes were surveyed. Results: Br revealed its anticancer effects by preventing the proliferation of cancer cells, inducing cytotoxicity, apoptosis, autophagy, and cellular oxidation in breast cancer cells. Moreover, its anti-inflammatory activity and immunomodulatory effects in the tumor environment can increase treatment outcomes. No significant side effects of this proteolytic substance have been reported, and it is a safe herbal constitution. Its combination with anticancer drugs such as cisplatin has revealed synergic effects. Besides reducing the toxicity of chemotherapy drugs, Br improves treatment outcomes. Conclusion: Br has shown promising anticancer effects against breast cancer in in vivo and in vitro studies. However, more clinical trial studies are needed to achieve more reliable results.