Medical Oncology

, 36:97 | Cite as

Caffeine enhances the anti-tumor effect of 5-fluorouracil via increasing the production of reactive oxygen species in hepatocellular carcinoma

  • Zhilei Wang
  • Chengxin Gu
  • Xinrui Wang
  • Yating Lang
  • Yanqin Wu
  • Xiaoqin Wu
  • Xifei Zhu
  • Kunyuan WangEmail author
  • Hui YangEmail author
Original Paper


The development of drug resistance affecting the prognosis of patients with hepatocellular carcinoma (HCC) leads to low survival rate of HCC patients. Caffeine is reported to have a function of protecting the liver and anti-tumor activity. Therefore, caffeine may be an ideal enhancer for HCC chemotherapy regimens. Our study showed that the combination of caffeine and 5-FU significantly inhibited the proliferation of HCC cells in vivo and in vitro comparing with caffeine or 5-FU monotherapy. The CI values of caffeine (0.5 mM) combined with 5-FU (25, 50 μM) were all less than 1, confirming that the utilization of drug combination has a synergistic inhibitory effect on the proliferation of HCC cells. Meanwhile, results of Western blot and TUNEL assays demonstrated that the apoptotic level of HCC cells in the combined group was significantly increased. The protein expression level of cleaved PARP was up-regulated, while the protein level of Bcl-2 and Bcl-xL was down-regulated. In addition, we found that ROS levels were increased in the 1 mM caffeine and 25 μM 5-FU combination group comparing with the control or single drug group. Taken together, this is the first study to demonstrate that the combination of caffeine and 5-FU inhibits HCC cells proliferation and promotes cellular apoptosis by regulating intracellular ROS production. The present data provides a basis for the application of caffeine combined with 5-FU as a novel chemotherapy regimen for HCC.


Caffeine 5-Fluouracil Hepatocellular carcinoma Proliferation Apoptosis Reactive oxygen species 


Author contributions

ZW generated, analyzed, and interpretated the data and prepared the manuscript. CG, XW, YL, YW, XW, and XZ generated, analyzed, and interpretated the data. KW generated the idea, designed the study, analyzed and interpretated the data, and prepared the manuscript. HY generated the idea, designed the study, analyzed and interpretated the data, and edited the manuscript.


This study was supported by Grants from Guangzhou Medical University Student Science and Technology Innovation Project (Grant No. 2017A027), the Science and Technology Program of Guangzhou (Grant No. 201707010470), and the National Natural Science Foundation of China (Grant No. 81372634) and the Guangdong Natural Science Funds for Distinguished Young Scholar (Grant No. S2013050014121).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouPeople’s Republic of China
  2. 2.The Second Clinical Medicine School of Guangzhou Medical UniversityGuangzhouPeople’s Republic of China

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