PHASE II TRIAL OF CURCUMIN IN ADVANCED HEAD AND NECK CANCER TREATMENT

Sunil Saini

Abstract


Introduction:

This study investigates the therapeutic potential of oral curcumin with piperine in the palliative management of advanced squamous cell carcinoma of head and neck region.

Methods:

40 patients with advanced, incurable or metastatic squamous cell carcinoma of head and neck region or those who have failed all standard treatment were included in this study without randomization. Patients received capsules of curcumin with piperine (3.6 g/day) for a period of 8 weeks.QOL was assessed using EORTC QLQ-C30 (version 3) & QLQ-H&N35 questionnaires.

Results:

A significant improvement in global health status, pain, fatigue, constipation and financial difficulty scores was observed at the end of treatment. The study therapy was well tolerated and no grade 3/4 toxicities were observed.

Conclusions:

The present study indicates the therapeutic potential of curcumin and piperine in the palliative treatment of advance head and neck cancer as a cost-effective substitute.

 


Keywords


Head and neck sq cell cancer (HNSCC), curcumin, quality of life (QOL)

Full Text:

PDF

References


Aggarwal BB, Kumar A, Bharti A: Anticancer potential of curcumin: Preclinical and clinical studies. Anticancer Research 23: 363-398, 2003.

Anto RJ, Mukhopadhyay A, Dening K and Aggarwal BB: Curcumin (diferuloylmethane) induces apoptosis through activation of caspase-8, BID cleavage and cytochrome c release: its suppression by ectopic expression of Bel-2 and Bcl-xl. Carcinogenesis 23:143-50, 2002

Pan MH, Chang WL, Lin-Shiau SY, Ho CT, Lin JK: Induction of apoptosis by garcinol and curcumin through cytochrome c release and activation of caspases in human leukaemia HL-60 cells. J Agric Food Chem 49:1464-74, 2001.

Moragoda L, Jaszewski R and Majumdar AP: Curcumin induced modulation of cell cycle and apoptosis in gastric and colon cancer cells. Anticancer Res 21:873-8, 2001

Mukhopadhyay A, Bueso-Ramos C, Chatterjee D, Pantazis P and Aggarwal BB: Curcumin down regulates cell survival mechanisms in human prostate cancer cell lines. Oncogene 20: 7597-609, 2001

Ondrey FG, Dong G, Sunwoo J, Chen Z, Wolf JS, Crowl-Bancroft CV,Mukaida N, Van Waes C. Constitutive activation of transcription factors NF-(kappa)B, AP-1, and NF-IL6 in human head and neck squamous cell carcinoma cell lines that express pro-inflammatory and pro-angiogenic cytokines. Mol Carcinog 1999 Oct; 26(2):119-29.

Jee SH, Shen SC, Tseng CR, Chiu Sc and Kuo ML: Curcumin induces a p-53 dependant apoptosis in human basal cell carcinoma cells. J Invest Dermatol 111:656-61, 1998.

Singh S and Aggarwal BB: Activation of transcription factor NF kappa B is suppressed by curcumin (diferuloylmethane) J BiolChem 270:24995-5000, 1995.

Sharma RA, Euden SA, Platton SL, Cooke DN, Shafayat A, Hewitt HR, Marczylo TH, Morgan B, Hemingway D, Plummer SM, Pirmohamed M, Gescher AJ, Steward WP. Phase I clinical trial of oral curcumin: biomarkers of systemic activity and compliance. Clin Cancer Res. 2004 Oct 15; 10(20):6847-54.

Cheng, A., Hsu CH, Lin JK, Hsu MM, Ho YF, Shen TS, Ko JY, Lin JT, Lin BR, Ming-Shiang W, Yu HS, Jee SH, Chen GS, Chen TM, Chen CA, Lai MK, Pu YS, Pan MH, Wang YJ, Tsai CC, Hsieh CY: Phase I clinical trial of curcumin, a chemo preventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res, 2001. 21(4B): p. 2895-900.

Aaronson N, Ahmedzai S, Bergman B, et al.: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993, 85:365.

Bjordal K, Hammerlid E, Ahlner-Elmqvist M, et al.: Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J ClinOncol 1999, 17:1008.

Bjordal K, Ahlner-Elmqvist M, Hammerlid E, et al.: A prospective study of quality of life in head and neck cancer patients. Part II: Longitudinal data. Laryngoscope 2001, 111:1440-1452.

Fayers P, Bottomley A: Quality of life research within the EORTC-the EORTC QLQ-C30. Eur J Cancer 2002, 38: 125-133.

Abeloff, M., Armitage, J., Niederhuber, J., Kastan, M. & McKenna, G. (Eds.): Clinical Oncology (2004). Elsevier, Philadelphia, PA.

Sharma RA, McLelland HR, Hill KA, Ireson CR, Euden SA, Manson MM, Pirmohamed M, Marnett LJ, Gescher AJ, Steward WP. Pharmacodynamic and pharmacokinetic study of oral Curcuma extract in patients with colorectal cancer. Clin Cancer Res. 2001; 7(7):1894-900.

Azuine MA, Bhide SV: Adjuvant chemoprevention of experimental cancer: catechin and dietary turmeric in forestomach and oral cancer models. J Ethnopharmacol. 1994 Dec; 44(3):211-7.

Nagabhushan M, Bhide SV: Curcumin as an inhibitor of cancer. J Am Coll Nutr. 1992 Apr; 11(2):192-8.

Kuttan R, Sudheeran PC and Joseph CD: Turmeric and curcumin as topical agents in cancer therapy. Tumour 73:129-31,1987

Aggarwal S, Takada Y, Singh S, Myers JN, Aggarwal BB.Inhibition of growth and survival of human head and neck squamous cell carcinoma cells by curcumin via modulation of nuclear factor-kappa signaling. 5: Int J Cancer. 2004 Sep 20; 111(5):679-92.

Leplege A, Hunt S. The problem of quality of life in medicine, JAMA 1997; 278: 47-50.

Gladis MM, Gosch EA, Dishuk NM, Critis-Christoph C. Quality of life: expanding the scope of clinical significance. J Consult Clin Psychol. 1999; 67:320–31.

Wan Leung S, Lee TF, Chien CY, Chao PJ, Tsai WL, Fang FM. Health-related quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer. 2011 Apr 12; 11:128.

Murphy BA. Advances in quality of life and symptom management for head and neck cancer patients. Curr Opin Oncol. 2009 May;21(3):242-7.

Goguen LA, Posner MR, Norris CM,Tishler RB, Wirth LJ, Annino DJ, Gagne RI. Dysphagia after sequential chemo radiation therapy for advanced head and neck cancer. Otolaryngol Head Neck Surg 2006; 134(6):916-22.

Bian X, Xu ZG, Lu CM, Tang PZ, Luo JB.Cancer and surgical treatment impact the quality of life in patients with head and neck cancer. Journal of clinical oncology 2005; 40(8):606-10.

Sharma R. A., Ireson C. R., Verschoyle R. D., Hill K. A., Williams M. L., Leuratti C., Manson M. M., Marnett L. J., Steward W. P., Gescher A. Effects of dietary curcumin on glutathione S-transferase and malondialdehyde-DNA adducts in rat liver and colon mucosa: relationship with drug levels. Clin. Cancer Res., 7: 1542-1548, 2001.

Ireson C. R., Orr S., Jones D. L., Verschoyle R., Lim C. K., Luo J. L., Howells L., Plummer S. M., Jukes R., Williams M., Steward W. P., Gescher A. Characterization of metabolites of the chemopreventive agent curcumin in humans and rat hepatocytes and in rat plasma and evaluation of their ability to inhibit cyclooxygenase-2 expression. Cancer Res., 61: 1058-1064, 2001.

Holder G. M., Plummer J. L., Ryan A. J. The metabolism and excretion of curcumin (1,7-bis-(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione) in the rat. Xenobiotica, 8: 761-768, 1978.

Wahlstrom B., Blennow G. A study on the fate of curcumin in the rat. Acta Pharmacol. Toxicol., 43: 86-92, 1978


Refbacks

  • There are currently no refbacks.