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Journal of Cancer Research and Clinical Oncology

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Open Access 01-05-2022 | Cytostatic Therapy | Original Article – Clinical Oncology

Complementary and alternative medicine (CAM) supplements in cancer outpatients: analyses of usage and of interaction risks with cancer treatment

Authors: Clemens P. J. G. Wolf, Tobias Rachow, Thomas Ernst, Andreas Hochhaus, Bijan Zomorodbakhsch, Susan Foller, Matthias Rengsberger, Michael Hartmann, Jutta Huebner

Published in: Journal of Cancer Research and Clinical Oncology | Issue 5/2022

Abstract

Purpose

The aim of our study was to analyze the use of complementary and alternative medicine (CAM) supplements, identify possible predictors, and analyze and compile potential interactions of CAM supplements with conventional cancer therapy.

Methods

We included outpatient cancer patients treated at a German university hospital in March or April 2020. Information was obtained from questionnaires and patient records. CAM–drug interactions were identified based on literature research for each active ingredient of the supplements consumed by the patients.

Results

37.4% of a total of 115 patients consumed CAM supplements. Potential interactions with conventional cancer treatment were identified in 51.2% of these patients. All types of CAM supplements were revealed to be a potential source for interactions: vitamins, minerals, food and plant extracts, and other processed CAM substances. Younger age (< 62 years) (p = 0.020, φc = 0.229) and duration of individual cancer history of more than 1 year (p = 0.006, φc = 0.264) were associated with increased likelihood of CAM supplement use. A wide range of different CAM supplement interactions were reviewed: effects of antioxidants, cytochrome (CYP) interactions, and specific agonistic or antagonistic effects with cancer treatment.

Conclusion

The interaction risks of conventional cancer therapy with over-the-counter CAM supplements seem to be underestimated. Supplements without medical indication, as well as overdoses, should be avoided, especially in cancer patients. To increase patient safety, physicians should address the risks of interactions in physician–patient communication, document the use of CAM supplements in patient records, and check for interactions.

Abuelgasim KA, Alsharhan Y, Alenzi T, Alhazzani A, Ali YZ, Jazieh AR (2018) The use of complementary and alternative medicine by patients with cancer: a cross-sectional survey in Saudi Arabia. BMC Complement Altern Med 18(1):88. https://doi.org/10.1186/s12906-018-2150-8CrossRefPubMedPubMedCentral

AbZ-Pharma GmbH (2016) Fachinformation Folsäure AbZ 5 mg Tabletten. AbZ-Pharma GmbH. https://www.fachinfo.de/api/fachinfo/pdf/010497. (Accessed 15 Apr 2021)

Al-Jenoobi FI, Al-Thukair AA, Abbas FA, Ansari MJ, Alkharfy KM, Al-Mohizea AM, Al-Suwayeh SA, Jamil S (2010) Effect of black seed on dextromethorphan O- and N-demethylation in human liver microsomes and healthy human subjects. Drug Metab Lett 4(1):51–55. https://doi.org/10.2174/187231210790980435CrossRefPubMed

Al-Jenoobi FI, Al-Thukair AA, Alam MA, Abbas FA, Al-Mohizea AM, Alkharfy KM, Al-Suwayeh SA (2015) Effect of Curcuma longa on CYP2D6- and CYP3A4-mediated metabolism of dextromethorphan in human liver microsomes and healthy human subjects. Eur J Drug Metab Pharmacokinet 40(1):61–66. https://doi.org/10.1007/s13318-014-0180-2CrossRefPubMed

Allocati N, Masulli M, Di Ilio C, Federici L (2018) Glutathione transferases: substrates, inihibitors and pro-drugs in cancer and neurodegenerative diseases. Oncogenesis 7(1):8. https://doi.org/10.1038/s41389-017-0025-3CrossRefPubMedPubMedCentral

Alsanad SM, Howard RL, Williamson EM (2016) An assessment of the impact of herb-drug combinations used by cancer patients. BMC Complement Altern Med 16(1):393. https://doi.org/10.1186/s12906-016-1372-xCrossRefPubMedPubMedCentral

Angelini A, Conti P, Ciofani G, Cuccurullo F, Di Ilio C (2013) Modulation of multidrug resistance P-glycoprotein activity by antiemetic compounds in human doxorubicin-resistant sarcoma cells (MES-SA/Dx-5): implications on cancer therapy. J Biol Regul Homeost Agents 27(4):1029–1037PubMed

Argyriou AA, Chroni E, Koutras A, Iconomou G, Papapetropoulos S, Polychronopoulos P, Kalofonos HP (2006) Preventing paclitaxel-induced peripheral neuropathy: a phase II trial of vitamin E supplementation. J Pain Symptom Manag 32(3):237–244. https://doi.org/10.1016/j.jpainsymman.2006.03.013CrossRefPubMed

Arumugam GP, Sundravel S, Shanthi P, Sachdanandam P (2006) Tamoxifen flare hypercalcemia: an additional support for gallium nitrate usage. J Bone Miner Metab 24(3):243–247. https://doi.org/10.1007/s00774-005-0678-4CrossRefPubMed

Baretta Z, Ghiotto C, Marino D, Jirillo A (2009) Aloe-induced hypokalemia in a patient with breast cancer during chemotherapy. Ann Oncol 20(8):1445–1446. https://doi.org/10.1093/annonc/mdp324CrossRefPubMed

Berretta M, Della Pepa C, Tralongo P, Fulvi A, Martellotta F, Lleshi A, Nasti G, Fisichella R, Romano C, De Divitiis C, Taibi R, Fiorica F, Di Francia R, Di Mari A, Del Pup L, Crispo A, De Paoli P, Santorelli A, Quagliariello V, Iaffaioli RV, Tirelli U, Facchini G (2017) Use of complementary and alternative medicine (CAM) in cancer patients: an Italian multicenter survey. Oncotarget 8(15):24401–24414. https://doi.org/10.18632/oncotarget.14224CrossRefPubMed

Branda RF, Naud SJ, Brooks EM, Chen Z, Muss H (2004) Effect of vitamin B12, folate, and dietary supplements on breast carcinoma chemotherapy-induced mucositis and neutropenia. Cancer 101(5):1058–1064. https://doi.org/10.1002/cncr.20484CrossRefPubMed

Cho H-J, Yoon I-S (2015) Pharmacokinetic interactions of herbs with cytochrome P450 and P-glycoprotein. Evid Based Complement Alternat Med 2015:736431. https://doi.org/10.1155/2015/736431CrossRefPubMedPubMedCentral

Chung JH, Choi DH, Choi JS (2009) Effects of oral epigallocatechin gallate on the oral pharmacokinetics of verapamil in rats. Biopharm Drug Dispos 30(2):90–93. https://doi.org/10.1002/bdd.644CrossRefPubMed

Cox MC, Low J, Lee J, Walshe J, Denduluri N, Berman A, Permenter MG, Petros WP, Price DK, Figg WD, Sparreboom A, Swain SM (2006) Influence of garlic (Allium sativum) on the pharmacokinetics of docetaxel. Clin Cancer Res 12(15):4636–4640. https://doi.org/10.1158/1078-0432.Ccr-06-0388CrossRefPubMed

Djuv A, Nilsen OG (2012) Aloe vera juice: IC₅₀ and dual mechanistic inhibition of CYP3A4 and CYP2D6. Phytother Res 26(3):445–451. https://doi.org/10.1002/ptr.3564CrossRefPubMed

Eagles SK, Gross AS, McLachlan AJ (2020) The effects of cruciferous vegetable-enriched diets on drug metabolism: a systematic review and meta-analysis of dietary intervention trials in humans. Clin Pharmacol Ther 108(2):212–227. https://doi.org/10.1002/cpt.1811CrossRefPubMed

Engdal S, Nilsen OG (2009) In vitro inhibition of CYP3A4 by herbal remedies frequently used by cancer patients. Phytother Res 23(7):906–912. https://doi.org/10.1002/ptr.2750CrossRefPubMed

Engdal S, Klepp O, Nilsen OG (2009) Identification and exploration of herb-drug combinations used by cancer patients. Integr Cancer Ther 8(1):29–36. https://doi.org/10.1177/1534735408330202CrossRefPubMed

Fahey AJ, Adrian Robins R, Constantinescu CS (2007) Curcumin modulation of IFN-beta and IL-12 signalling and cytokine induction in human T cells. J Cell Mol Med 11(5):1129–1137. https://doi.org/10.1111/j.1582-4934.2007.00089.xCrossRefPubMedPubMedCentral

Ferreira PMP, Rodrigues L, de Alencar Carnib LP, de Lima Sousa PV, Nolasco Lugo LM, Nunes NMF, Do Nascimento Silva J, Da Silva AL, de Macêdo Gonçalves Frota K (2018) Cruciferous vegetables as antioxidative, chemopreventive and antineoplasic functional foods: preclinical and clinical evidences of sulforaphane against prostate cancers. Curr Pharm Des 24(40):4779–4793. https://doi.org/10.2174/1381612825666190116124233CrossRefPubMed

Firkins R, Eisfeld H, Keinki C, Buentzel J, Hochhaus A, Schmidt T, Huebner J (2018) The use of complementary and alternative medicine by patients in routine care and the risk of interactions. J Cancer Res Clin Oncol 144(3):551–557. https://doi.org/10.1007/s00432-018-2587-7CrossRefPubMed

Foster BC, Foster MS, Vandenhoek S, Krantis A, Budzinski JW, Arnason JT, Gallicano KD, Choudri S (2001) An in vitro evaluation of human cytochrome P450 3A4 and P-glycoprotein inhibition by garlic. J Pharm Pharm Sci 4(2):176–184. https://sites.ualberta.ca/~csps/JPPS4(2)/B.Foster/Garlic.pdf. (Accessed 15 Apr 2021)

García-Cortés M, Robles-Díaz M, Ortega-Alonso A, Medina-Caliz I, Andrade RJ (2016) Hepatotoxicity by dietary supplements: a tabular listing and clinical characteristics. Int J Mol Sci 17(4):537. https://doi.org/10.3390/ijms17040537CrossRefPubMedPubMedCentral

Golden EB, Lam PY, Kardosh A, Gaffney KJ, Cadenas E, Louie SG, Petasis NA, Chen TC, Schönthal AH (2009) Green tea polyphenols block the anticancer effects of bortezomib and other boronic acid-based proteasome inhibitors. Blood 113(23):5927–5937. https://doi.org/10.1182/blood-2008-07-171389CrossRefPubMed

Guo X, Mei N (2016) Aloe vera: a review of toxicity and adverse clinical effects. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 34(2):77–96. https://doi.org/10.1080/10590501.2016.1166826CrossRefPubMedPubMedCentral

Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Carrier J, Khan IA, Edwards DJ, Shah A (2004) In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: citrus aurantium, echinacea purpurea, milk thistle, and saw palmetto. Clin Pharmacol Ther 76(5):428–440. https://doi.org/10.1016/j.clpt.2004.07.007CrossRefPubMed

Heaney ML, Gardner JR, Karasavvas N, Golde DW, Scheinberg DA, Smith EA, O’Connor OA (2008) Vitamin C antagonizes the cytotoxic effects of antineoplastic drugs. Cancer Res 68(19):8031–8038. https://doi.org/10.1158/0008-5472.Can-08-1490CrossRefPubMedPubMedCentral

HEUMANN PHARMA GmbH & Co. Generica KG (2015) Fachinformation Folsäure Heumann 5 mg Tabletten. HEUMANN PHARMA GmbH & Co. Generica KG. https://www.fachinfo.de/api/fachinfo/pdf/000307. (Accessed 19 Feb 2021)

Ho BE, Shen DD, McCune JS, Bui T, Risler L, Yang Z, Ho RJ (2010) Effects of garlic on cytochromes P450 2C9- and 3A4-mediated drug metabolism in human hepatocytes. Sci Pharm 78(3):473–481. https://doi.org/10.3797/scipharm.1002-11CrossRefPubMedPubMedCentral

Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M (2012) How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 11(3):187–203. https://doi.org/10.1177/1534735411423920CrossRefPubMed

Huebner J (2012) Komplementäre Onkologie: supportive Maßnahmen und evidenzbasierte Empfehlungen, vol 2. Schattauer

Huebner J, Muenstedt K, Prott FJ, Stoll C, Micke O, Buentzel J, Muecke R, Senf B (2014) Online survey of patients with breast cancer on complementary and alternative medicine. Breast Care (Basel) 9(1):60–63. https://doi.org/10.1159/000360381CrossRef

JANSSEN-CILAG INTERNATIONAL NV (2019) Fachinformation VELCADE^® 3.5 mg Pulver. Janssen-Cilag International NV. https://www.fachinfo.de/api/fachinfo/pdf/008387. (Accessed 15 Apr 2021)

Joshi SS, Kuszynski CA, Bagchi M, Bagchi D (2000) Chemopreventive effects of grape seed proanthocyanidin extract on Chang liver cells. Toxicology 155(1–3):83–90. https://doi.org/10.1016/s0300-483x(00)00280-8CrossRefPubMed

Jung AY, Cai X, Thoene K, Obi N, Jaskulski S, Behrens S, Flesch-Janys D, Chang-Claude J (2019) Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy. Am J Clin Nutr 109(1):69–78. https://doi.org/10.1093/ajcn/nqy223CrossRefPubMed

Kang BY, Song YJ, Kim KM, Choe YK, Hwang SY, Kim TS (1999) Curcumin inhibits Th1 cytokine profile in CD4+ T cells by suppressing interleukin-12 production in macrophages. Br J Pharmacol 128(2):380–384. https://doi.org/10.1038/sj.bjp.0702803CrossRefPubMedPubMedCentral

Kennedy J (2005) Herb and supplement use in the US adult population. Clin Ther 27(11):1847–1858. https://doi.org/10.1016/j.clinthera.2005.11.004CrossRef

Kim IS, Kim SY, Yoo HH (2012) Effects of an aqueous-ethanolic extract of ginger on cytochrome P450 enzyme-mediated drug metabolism. Pharmazie 67(12):1007–1009. https://doi.org/10.1691/ph.2012.2595CrossRefPubMed

Kimura Y, Ito H, Hatano T (2010) Effects of mace and nutmeg on human cytochrome P450 3A4 and 2C9 activity. Biol Pharm Bull 33(12):1977–1982. https://doi.org/10.1248/bpb.33.1977CrossRefPubMed

Lee AH, Ingraham SE, Kopp M, Foraida MI, Jazieh AR (2006) The incidence of potential interactions between dietary supplements and prescription medications in cancer patients at a Veterans Administration Hospital. Am J Clin Oncol 29(2):178–182. https://doi.org/10.1097/01.coc.0000209369.44100.25CrossRefPubMed

Li J, Liu H, Ramachandran S, Waypa GB, Yin JJ, Li CQ, Han M, Huang HH, Sillard WW, Vanden Hoek TL, Shao ZH (2010) Grape seed proanthocyanidins ameliorate doxorubicin-induced cardiotoxicity. Am J Chin Med 38(3):569–584. https://doi.org/10.1142/s0192415x10008068CrossRefPubMed

Loquai C, Dechent D, Garzarolli M, Kaatz M, Kaehler K, Kurschat P, Meiss F, Stein A, Nashan D, Micke O, Muecke R, Muenstedt K, Stoll C, Schmidtmann I, Huebner J (2016) Risk of interactions between complementary and alternative medicine and medication for comorbidities in patients with melanoma. Med Oncol 33(5):52. https://doi.org/10.1007/s12032-016-0764-6CrossRefPubMed

Loquai C, Schmidtmann I, Garzarolli M, Kaatz M, Kaehler K, Kurschat P, Meiss F, Micke O, Muecke R, Muenstedt K, Nashan D, Stein A, Stoll C, Dechent D, Huebner J (2017) Interactions from complementary and alternative medicine in patients with melanoma. Melanoma Res 27(3):238–242. https://doi.org/10.1097/CMR.0000000000000339CrossRefPubMed

Lu Y, Cederbaum AI (2006) Cisplatin-induced hepatotoxicity is enhanced by elevated expression of cytochrome P450 2E1. Toxicol Sci 89(2):515–523. https://doi.org/10.1093/toxsci/kfj031CrossRefPubMed

Lund EL, Quistorff B, Spang-Thomsen M, Kristjansen PE (1998) Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiol 43(5):505–506. https://doi.org/10.1007/bf02820805CrossRef

Mach CM, Fugii H, Wakame K, Smith J (2008) Evaluation of active hexose correlated compound hepatic metabolism and potential for drug interactions with chemotherapy agents. J Soc Integr Oncol 6(3):105–109. http://ahccpublishedresearch.com/articles/wp-content/uploads/2016/07/IV.K.-AHCC-2008-Mach-In-Vitro.pdf. (Accessed 15 Apr 2021)

Markowitz JS, Devane CL, Chavin KD, Taylor RM, Ruan Y, Donovan JL (2003) Effects of garlic (Allium sativum L.) supplementation on cytochrome P450 2D6 and 3A4 activity in healthy volunteers. Clin Pharmacol Ther 74(2):170–177. https://doi.org/10.1016/s0009-9236(03)00148-6CrossRefPubMed

Mazzanti G, Menniti-Ippolito F, Moro PA, Cassetti F, Raschetti R, Santuccio C, Mastrangelo S (2009) Hepatotoxicity from green tea: a review of the literature and two unpublished cases. Eur J Clin Pharmacol 65(4):331–341. https://doi.org/10.1007/s00228-008-0610-7CrossRefPubMed

McCune JS, Hatfield AJ, Blackburn AA, Leith PO, Livingston RB, Ellis GK (2004) Potential of chemotherapy-herb interactions in adult cancer patients. Support Care Cancer 12(6):454–462. https://doi.org/10.1007/s00520-004-0598-1CrossRefPubMed

Micke O, Bruns F, Glatzel M, Schönekaes K, Micke P, Mücke R, Büntzel J (2009) Predictive factors for the use of complementary and alternative medicine (CAM) in radiation oncology. Eur J Integr Med 1(1):19–25. https://doi.org/10.1016/j.eujim.2009.02.001CrossRef

Molassiotis A, Fernández-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AM-A, Platin N, Kearney N, Patiraki E (2005) Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 16(4):655–663. https://doi.org/10.1093/annonc/mdi110CrossRefPubMed

Nabekura T, Kamiyama S, Kitagawa S (2005) Effects of dietary chemopreventive phytochemicals on P-glycoprotein function. Biochem Biophys Res Commun 327(3):866–870. https://doi.org/10.1016/j.bbrc.2004.12.081CrossRefPubMed

Naing A, Stephen SK, Frenkel M, Chandhasin C, Hong DS, Lei X, Falchook G, Wheler JJ, Fu S, Kurzrock R (2011) Prevalence of complementary medicine use in a phase 1 clinical trials program: the MD Anderson Cancer Center Experience. Cancer 117(22):5142–5150. https://doi.org/10.1002/cncr.26164CrossRefPubMed

NCCIH (2018) Complementary, alternative, or integrative health: what’s in a name? National Center for Complementary and Integrative Health (NCCIH). https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name. (Accessed 15 Apr 2021)

Nestora S, Merlier F, Prost E, Haupt K, Rossi C, Tse Sum Bui B (2016) Solid-phase extraction of betanin and isobetanin from beetroot extracts using a dipicolinic acid molecularly imprinted polymer. J Chromatogr A 1465:47–54. https://doi.org/10.1016/j.chroma.2016.08.069CrossRefPubMed

Pace A, Savarese A, Picardo M, Maresca V, Pacetti U, Del Monte G, Biroccio A, Leonetti C, Jandolo B, Cognetti F, Bove L (2003) Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol 21(5):927–931. https://doi.org/10.1200/jco.2003.05.139CrossRefPubMed

Pae HO, Oh GS, Seo WG, Shin MK, Hong SG, Lee HS, Chung HT (2001) Mistletoe lectin synergizes with paclitaxel in human SK-hep1 hepatocarcinoma cells. Immunopharmacol Immunotoxicol 23(4):531–540. https://doi.org/10.1081/iph-100108599CrossRefPubMed

Perrone G, Hideshima T, Ikeda H, Okawa Y, Calabrese E, Gorgun G, Santo L, Cirstea D, Raje N, Chauhan D, Baccarani M, Cavo M, Anderson KC (2009) Ascorbic acid inhibits antitumor activity of bortezomib in vivo. Leukemia 23(9):1679–1686. https://doi.org/10.1038/leu.2009.83CrossRefPubMed

Petri H (2017) Das Interaktionspotenzial konventioneller Zytostatika. Dtsch Arztebl 114(48):19–21. https://doi.org/10.3238/PersOnko/2017.12.01.04CrossRef

Pohl H, Reidy JA (1989) Vitamin C intake influences the bleomycin-induced chromosome damage assay: implications for detection of cancer susceptibility and chromosome breakage syndromes. Mutat Res 224(2):247–252. https://doi.org/10.1016/0165-1218(89)90163-8CrossRefPubMed

Portakal O, Ozkaya O, Erden Inal M, Bozan B, Koşan M, Sayek I (2000) Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients. Clin Biochem 33(4):279–284. https://doi.org/10.1016/s0009-9120(00)00067-9CrossRefPubMed

Qiu J-X, Zhou Z-W, He Z-X, Zhang X, Zhou S-F, Zhu S (2015) Estimation of the binding modes with important human cytochrome P450 enzymes, drug interaction potential, pharmacokinetics, and hepatotoxicity of ginger components using molecular docking, computational, and pharmacokinetic modeling studies. Drug Des Devel Ther 9:841–866. https://doi.org/10.2147/DDDT.S74669CrossRefPubMedPubMedCentral

Quintanilha JCF, de Sousa VM, Visacri MB, Amaral LS, Santos RMM, Zambrano T, Salazar LA, Moriel P (2017) Involvement of cytochrome P450 in cisplatin treatment: implications for toxicity. Cancer Chemother Pharmacol 80(2):223–233. https://doi.org/10.1007/s00280-017-3358-xCrossRefPubMed

Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE (2000) Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18(13):2505–2514. https://doi.org/10.1200/jco.2000.18.13.2505CrossRefPubMed

Rusciani L, Proietti I, Rusciani A, Paradisi A, Sbordoni G, Alfano C, Panunzi S, De Gaetano A, Lippa S (2006) Low plasma coenzyme Q10 levels as an independent prognostic factor for melanoma progression. J Am Acad Dermatol 54(2):234–241. https://doi.org/10.1016/j.jaad.2005.08.031CrossRefPubMed

Savranoglu S, Tumer TB (2013) Inhibitory effects of spirulina platensis on carcinogen-activating cytochrome P450 isozymes and potential for drug interactions. Int J Toxicol 32(5):376–384. https://doi.org/10.1177/1091581813503887CrossRefPubMed

Schink M, Dehus O (2017) Effects of mistletoe products on pharmacokinetic drug turnover by inhibition and induction of cytochrome P450 activities. BMC Complement Altern Med 17(1):521. https://doi.org/10.1186/s12906-017-2028-1CrossRefPubMedPubMedCentral

Sharma G, Tyagi AK, Singh RP, Chan DC, Agarwal R (2004) Synergistic anti-cancer effects of grape seed extract and conventional cytotoxic agent doxorubicin against human breast carcinoma cells. Breast Cancer Res Treat 85(1):1–12. https://doi.org/10.1023/b:Brea.0000020991.55659.59CrossRefPubMed

Shin SC, Choi JS (2009) Effects of epigallocatechin gallate on the oral bioavailability and pharmacokinetics of tamoxifen and its main metabolite, 4-hydroxytamoxifen, in rats. Anticancer Drugs 20(7):584–588. https://doi.org/10.1097/CAD.0b013e32832d6834CrossRefPubMed

Skyvalidas D, Mavropoulos A, Tsiogkas S, Dardiotis E, Liaskos C, Mamuris Z, Roussaki-Schulze A, Sakkas LI, Zafiriou E, Bogdanos DP (2020) Curcumin mediates attenuation of pro-inflammatory interferon γ and interleukin 17 cytokine responses in psoriatic disease, strengthening its role as a dietary immunosuppressant. Nutr Res 75:95–108. https://doi.org/10.1016/j.nutres.2020.01.005CrossRefPubMed

Somasundaram S, Edmund NA, Moore DT, Small GW, Shi YY, Orlowski RZ (2002) Dietary curcumin inhibits chemotherapy-induced apoptosis in models of human breast cancer. Cancer Res 62(13):3868–3875. https://cancerres.aacrjournals.org/content/canres/62/13/3868.full.pdf. (Accessed 15 Apr 2021)

Teichfischer P, Muenstedt K (2011) Zur Definition der Komplementär- und Alternativmedizin (CAM). Forum 26(5):16. https://doi.org/10.1007/s12312-011-0671-xCrossRef

van Erp NP, Baker SD, Zhao M, Rudek MA, Guchelaar HJ, Nortier JW, Sparreboom A, Gelderblom H (2005) Effect of milk thistle (Silybum marianum) on the pharmacokinetics of irinotecan. Clin Cancer Res 11(21):7800–7806. https://doi.org/10.1158/1078-0432.Ccr-05-1288CrossRefPubMed

Volak LP, Ghirmai S, Cashman JR, Court MH (2008) Curcuminoids inhibit multiple human cytochromes P450, UDP-glucuronosyltransferase, and sulfotransferase enzymes, whereas piperine is a relatively selective CYP3A4 inhibitor. Drug Metab Dispos 36(8):1594–1605. https://doi.org/10.1124/dmd.108.020552CrossRefPubMed

Wanwimolruk S, Wong K, Wanwimolruk P (2009) Variable inhibitory effect of different brands of commercial herbal supplements on human cytochrome P-450 CYP3A4. Drug Metabol Drug Interact 24(1):17–35. https://doi.org/10.1515/dmdi.2009.24.1.17CrossRefPubMed

Wei R, Hu Y, Xiong J (2019) Effect size reporting practices in applied linguistics research: a study of one major journal. SAGE open 9(2). https://doi.org/10.1177/2158244019850035

Werneke U, Earl J, Seydel C, Horn O, Crichton P, Fannon D (2004) Potential health risks of complementary alternative medicines in cancer patients. Br J Cancer 90(2):408–413. https://doi.org/10.1038/sj.bjc.6601560CrossRefPubMedPubMedCentral

Wiernik PH, Yeap B, Vogl SE, Kaplan BH, Comis RL, Falkson G, Davis TE, Fazzini E, Cheuvart B, Horton J (1992) Hexamethylmelamine and low or moderate dose cisplatin with or without pyridoxine for treatment of advanced ovarian carcinoma: a study of the Eastern Cooperative Oncology Group. Cancer Invest 10(1):1–9. https://doi.org/10.3109/07357909209032783CrossRefPubMed

Wode K, Henriksson R, Sharp L, Stoltenberg A, Hök Nordberg J (2019) Cancer patients’ use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC Complement Altern Med 19(1):62. https://doi.org/10.1186/s12906-019-2452-5CrossRefPubMedPubMedCentral

Wolf C, Rachow T, Ernst T, Hochhaus A, Zomorodbakhsch B, Foller S, Rengsberger M, Hartmann M, Hübner J (2021) Interactions in cancer treatment considering cancer therapy, concomitant medications, food, herbal medicine and other supplements. J Cancer Res Clin Oncol. https://doi.org/10.1007/s00432-021-03625-3CrossRefPubMedPubMedCentral

Xu Y, Zhang Y, Zhou F, Zheng Y, Zhu X (2011) [Human pregnane X receptor-mediated transcriptional regulation of CYP3A4 by extracts of 7 traditional Chinese medicines]. Zhongguo Zhong Yao Za Zhi 36(11):1524–1527. https://pubmed.ncbi.nlm.nih.gov/22779192/. (Accessed 15 Apr 2021)

Zeller T, Muenstedt K, Stoll C, Schweder J, Senf B, Ruckhaeberle E, Becker S, Serve H, Huebner J (2013) Potential interactions of complementary and alternative medicine with cancer therapy in outpatients with gynecological cancer in a comprehensive cancer center. J Cancer Res Clin Oncol 139(3):357–365. https://doi.org/10.1007/s00432-012-1336-6CrossRefPubMed

Title: Complementary and alternative medicine (CAM) supplements in cancer outpatients: analyses of usage and of interaction risks with cancer treatment
Authors: Clemens P. J. G. Wolf
Tobias Rachow
Thomas Ernst
Andreas Hochhaus
Bijan Zomorodbakhsch
Susan Foller
Matthias Rengsberger
Michael Hartmann
Jutta Huebner
Publication date: 01-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Cytostatic Therapy
Cancer Therapy
Published in: Journal of Cancer Research and Clinical Oncology / Issue 5/2022
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-021-03675-7

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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Other articles of this Issue 5/2022

Epithelial circulating tumor cells with a heterogeneous phenotype are associated with metastasis in NSCLC

Short-term outcome of Ivor Lewis esophagectomy following neoadjuvant chemoradiation versus perioperative chemotherapy in patients with locally advanced adenocarcinoma of the esophagus and gastroesophageal junction: a propensity score-matched analysis

Socioeconomic disparities in endometrial cancer survival in Germany: a survival analysis using population-based cancer registry data

Overuse of follow-up chest computed tomography in patients with incidentally identified nodules suspicious for lung cancer

Dexa-BEAM versus MIFAP as salvage regimen for recurrent lymphoma: a prospective randomized multicenter phase II trial with a median follow-up of 14.4 years

The eagle sign: a new preoperative MRI-based tool for predicting topographic correlation between craniopharyngioma and hypothalamus

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage