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The combinatory effects of natural products and chemotherapy drugs and their mechanisms in breast cancer treatment

  • Yubo Zhang
  • Huajun Li
  • Jing Zhang
  • Chaoran Zhao
  • Shuai Lu
  • Jinping QiaoEmail author
  • Mei HanEmail author
Article
  • 12 Downloads

Abstract

Breast cancer is the leading cause of cancer-related death among females. The global morbidity and mortality associated with breast cancer have recently been increasing. Surgery, radiation therapy, chemotherapy, endocrine therapy and biotargeted therapy, alone or in combination, are commonly used for breast cancer treatment. However, diverse side effects can be caused by the current treatments. Natural products derived from plants have almost no toxicity and side effects, with many functions and therapeutic activities. Many preclinical studies have reported the potential of natural products to enhance the effects of chemotherapy drugs in breast cancer treatment. The combined effects of these treatments in breast cancer are summarized in this review, as well as the in vivo and in vitro mechanisms. Natural products enhanced anti-cancer effects and apoptosis via the EGFR, PI3K-Akt, Wnt and other pathways. The toxicity, side effects, and drug resistance were reduced with the combination therapies. The combination of chemotherapy drugs and natural products could be a promising and effective strategy to treat breast cancer.

Keywords

Breast cancer Natural products Chemotherapy Combinatory effect 

Abbreviations

ABC transporters

ATP-binding cassette transporters

Akt

Protein kinase B

AMPK

Adenosine 5′-monophosphate-activated protein kinase

APBI

Accelerated partial-breast irradiation

Bax

Bcl-2-like protein 4

Bcl-2

B-cell lymphoma 2

BCRP

Breast cancer resistance protein

BCSCs

Breast cancer stem cells

CDK2

Cyclin-dependent kinase 2

CDK4

Cyclin-dependent kinase 4

CI

Combination index

EGFR

Epidermal growth factor receptor

ER

Estrogen receptor

ERK1/2

Extracellular regulated protein kinase 1/2

ERα

Estrogen receptor alpha

ERβ2

Estrogen receptor beta 2

FAK

Focal adhesion kinase

Fas

Fas receptor

GST

Glutathione-S-transferase

HER-2

Human epidermal growth factor receptor-2

HER-2+

Human epidermal growth factor receptor-2-positive

HIF-1

Alpha hypoxia-inducible factor-1

iPLA2

Independent phospholipase A2

IκBα

Inhibitor of NF-κB alpha

MMP-9

Matrix metalloproteinase-9

MRP1

Multidrug resistance-associated protein 1

mTOR

Mammalian target of rapamycin

NCCN

National comprehensive cancer network

NF-κB

Nuclear factor-κB

PARP-1

Poly ADP-ribose polymerase

P-gp

P-glycoprotein

PI3k

Phosphoinositide 3 kinase

PR

Progesterone receptor

Rb

Retinoblastoma

ROS

Reactive oxygen species

STAT3

Signal transducer and activator of transcription 3

TNBC

Triple-negative breast cancer

Twist1

Twist-related protein 1

WBI

Whole-breast irradiation

Wnt

Wingless/integrated

p-ERK1/2

Phosphorylated extracellular signal-regulated kinase 1/2

p-AKT

Phosphorylated protein kinase B

AIF

Apoptosis-inducing factor

ABCG2

ATP-binding cassette super-family G member 2

EZH2

Enhancer of zeste homolog 2

Notes

Acknowledgements

This study was funded by the Asia–Pacific Cancer Research Foundation and the National Key Research and Development Program of China (2017YFC0113305).

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© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of ChemistryBeijing Normal UniversityBeijingChina

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