Document Type : Original Article

Authors

1 Department of Family and Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Hematology and Oncology, Department of Internal Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.30476/mejc.2023.94508.1734

Abstract

Background: Cancer has become a significant health challenge in recent decades. The Taxane family is one of the popular chemotherapeutic agents which can cause hepatic injury. The present study was conducted with the aim of evaluating the hepatoprotective effect of Curcumin on cancer patients treated with Taxanes.
Method: This controlled randomized clinical trial (RCT) has been conducted on 80 patients with either breast, ovary, or pancreas cancer randomly allocated to the intervention group (n = 37) treated with daily 47.5 mg Curcumin extract or the control group (n = 34) treated with placebo. Hepatic indices, including alanine transaminase, aspartate transaminase, total bilirubin, and alkaline phosphatase, were measured and compared at baseline within three and six weeks after the intervention initiation.
Results: The assessments revealed a remarkable increase in all of the indices in both groups by the time (P < 0.05), while these increases were remarkably less among the patients treated with curcumin in comparison with placebo treatment (P < 0.05). The Mean ± standard deviation (SD) was 26.3 ± 8.6 and 29.8 ± 10.5 for aspartate transaminase, 25.5 ± 8.3 and 30.2 ± 10.6 for alanine transaminase, 122.9 ± 18.02 and 126.8 ± 16.9 for alkaline phosphatase, 0.88 ± 0.10 and 0.95 ± 0.12 for bilirubin in the intervention and control groups, respectively.
Conclusion: Based on the current study's findings, Curcumin could act relatively as a hepatoprotective agent against Taxane; however, further studies are strongly recommended to determine the dosage and consumption instruction of this agent for patients with cancer.

Keywords

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination, and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.30476/mejc.2023.94508.1734

  1. Liu Z, Huang P, Law S, Tian H, Leung W, Xu C. Preventive effect of Curcumin against chemotherapy-induced side-effects. Front Pharmacol. 2018;9:1374. doi: 10.3389/fphar.2018.01374.
  2. Thun M, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D. Cancer epidemiology and prevention. 4th ed. Oxford University Press; 2017. 1328p.
  3. Bakkers C, van Erning FN, Rovers KP, Nienhuijs SW, Burger JW, Lemmens VE, et al. Long-term survival after hyperthermic intraperitoneal chemotherapy using mitomycin C or oxaliplatin in colorectal cancer patients with synchronous peritoneal metastases: A nationwide comparative study. Eur J Surg Oncol. 2020;46(10 Pt A):1902-7. doi: 10.1016/j.ejso.2020.04.018.
  4. Dai J, Sun L, Jin K, Jiang G, Zhang P. Identifiable and unidentifiable factors influencing lymph node examination and adjuvant chemotherapy in stage I lung cancer. J Thorac Oncol. 2020;15(5):e78-e79. doi: 10.1016/j.jtho.2020.02.016.
  5. Soni VK, Shukla D, Kumar A, Vishvakarma NK. Curcumin circumvent lactate-induced chemoresistance in hepatic cancer cells through modulation of hydroxycarboxylic acid receptor-1. Int J Biochem Cell Biol. 2020;123:105752. doi: 10.1016/j.biocel.2020.105752.
  6. Seetharam S, Thankamony P, Gopakumar KG, Krishna KMJ. Higher incidence of syndrome of inappropriate antidiuretic hormone secretion during induction chemotherapy of acute lymphoblastic leukemia in indian children. Indian J Cancer. 2019;56(4):320-4. doi: 10.4103/ijc.IJC_737_18.
  7. van Eijk M, Boosman RJ, Schinkel AH, Huitema ADR, Beijnen JH. Cytochrome P450 3A4, 3A5, and 2C8 expression in breast, prostate, lung, endometrial, and ovarian tumors: relevance for resistance to taxanes. Cancer Chemother Pharmacol. 2019;84(3):487-99. doi: 10.1007/s00280-019-03905-3.
  8. Hooker AC, Ten Tije AJ, Carducci MA, Weber J, Garrett-Mayer E, Gelderblom H, et al. Population pharmacokinetic model for docetaxel in patients with varying degrees of liver function: incorporating cytochrome P4503A activity measurements. Clin Pharmacol Ther. 2008;84(1):111-8. doi: 10.1038/sj.clpt.6100476.
  9. Goel A, Kunnumakkara AB, Aggarwal BB. Curcumin as "Curecumin": from kitchen to clinic. Biochem Pharmacol. 2008;75(4):787-809. doi: 10.1016/j.bcp.2007.08.016.
  10. Khan H, Ullah H, Nabavi SM. Mechanistic insights of hepatoprotective effects of curcumin: Therapeutic updates and future prospects. Food Chem Toxicol. 2019;124:182-91. doi: 10.1016/j.fct.2018.12.002.
  11. Rahmani AH, Alsahli MA, Aly SM, Khan MA, Aldebasi YH. Role of Curcumin in disease prevention and treatment. Adv Biomed Res. 2018;7:38. doi: 10.4103/abr.abr_147_16.
  12. Heidari Z, Mohammadi S, Yousefi Taba M. Protective effect of Curcumin on the density of hippocampal dark neurons in mice model of aging induced by D-galactose: a Histopathological study. Pharm Biomed Res. 2019;5(4):63-8.
  13. Priyadarsini KI. Chemical and structural features influencing the biological activity of curcumin. Curr Pharm Des. 2013;19(11):2093-100. doi: 10.2174/138161213805289228.
  14. Shaterpour M, Shaki F, Ghasemi M, Jafari-Sabet M, Ziar A, Ataee R. The protective effect of curcumin against lithium-induced nephrotoxicity in rats. Pharm Biomed Res. 2017;3(2):33-8.doi: 10.29252/pbr.3.2.33.
  15. Labban L. Medicinal and pharmacological properties of Turmeric (Curcuma longa): A review. Int J Pharm Biomed Sci. 2014;5:17-23.
  16. Wang Z, Qi F, Cui Y, Zhao L, Sun X, Tang W, et al. An update on Chinese herbal medicines as adjuvant treatment of anticancer therapeutics. Biosci Trends. 2018;12(3):220-39. doi: 10.5582/bst.2018.01144.
  17. Wang R, Sun Q, Wang F, Liu Y, Li X, Chen T, et al. Efficacy and safety of Chinese herbal medicine on ovarian cancer after reduction surgery and adjuvant chemotherapy: a systematic review and meta-analysis. Front Oncol. 2019;9:730. doi: 10.3389/fonc.2019.00730.
  18. Lin SR, Chang CH, Hsu CF, Tsai MJ, Cheng H, Leong MK, et al. Natural compounds as potential adjuvants to cancer therapy: Preclinical evidence. Br J Pharmacol. 2020;177(6):1409-23. doi: 10.1111/bph.14816.
  19. Ghandadi M, Sahebkar A. Curcumin: an effective inhibitor of interleukin-6. Curr Pharm Des. 2017;23(6):921-31. doi: 10.2174/1381612822666161006151605.
  20. Soni KB, Rajan A, Kuttan R. Reversal of aflatoxin induced liver damage by turmeric and curcumin. Cancer Lett. 1992;66(2):115-21. doi: 10.1016/0304-3835(92)90223-i. 1394115.
  21. García-Niño WR, Pedraza-Chaverrí J. Protective effect of curcumin against heavy metals-induced liver damage. Food Chem Toxicol. 2014;69:182-201. doi: 10.1016/j.fct.2014.04.016.
  22. Wickenberg J, Ingemansson SL, Hlebowicz J. Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects. Nutr J. 2010;9:43. doi: 10.1186/1475-2891-9-43.
  23. Jia R, Li Y, Cao L, Du J, Zheng T, Qian H, et al. Antioxidative, anti-inflammatory and hepatoprotective effects of resveratrol on oxidative stress-induced liver damage in tilapia (Oreochromis niloticus). Comp Biochem Physiol C Toxicol Pharmacol. 2019;215:56-66. doi: 10.1016/j.cbpc.2018.10.002.
  24. Jaeschke H, McGill MR, Ramachandran A. Oxidant stress, mitochondria, and cell death mechanisms in drug-induced liver injury: lessons learned from acetaminophen hepatotoxicity. Drug Metab Rev. 2012;44(1):88-106. doi: 10.3109/03602532.2011.602688.
  25. Costa ML, Rodrigues JA, Azevedo J, Vasconcelos V, Eiras E, Campos MG. Hepatotoxicity induced by paclitaxel interaction with turmeric in association with a microcystin from a contaminated dietary supplement. Toxicon. 2018;150:207-11. doi: 10.1016/j.toxicon.2018.05.022.
  26. Wang Y, Hu PC, Gao FF, Lv JW, Xu S, Kuang CC, et al. The protective effect of curcumin on hepatotoxicity and ultrastructural damage induced by cisplatin. Ultrastruct Pathol. 2014;38(5):358-62. doi: 10.3109/01913123.2014.933289.
  27. Akbari S, Kariznavi E, Jannati M, Elyasi S, Tayarani-Najaran Z. Curcumin as a preventive or therapeutic measure for chemotherapy and radiotherapy induced adverse reaction: A comprehensive review. Food Chem Toxicol. 2020;145:111699. doi: 10.1016/j.fct.2020.111699.
  28. López-Lázaro M. Anticancer and carcinogenic properties of curcumin: considerations for its clinical development as a cancer chemopreventive and chemotherapeutic agent. Mol Nutr Food Res. 2008;52 Suppl 1:S103-27. doi: 10.1002/mnfr.200700238.