Skip to main content

Advertisement

Log in

Combination of Chinese and Western Medicine to Prevent and Reverse Resistance of Cancer Cells to Anticancer Drugs

  • Feature Article
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Resistance to anticancer drugs is a major problem in oncology, which causes the failure of antitumor treatment. A variety of factors contribute to drug resistance, including drug efflux and metabolism, tumor cell heterogeneity, tumor microenvironment stress-induced genetic or epigenetic alterations in the cancer cells and so on. However, how to circumvent this resistance to improve anticancer efficacy remains to be determined. To circumvent chemotherapeutic resistance, many reversal agents have been developed, but most of them fail in clinical trials due to severe adverse effects. Recently, several natural products have been reported to augment sensitivity or overcome resistance of anticancer chemotherapeutic drugs, including elemene, curcumin, Shenqi Fuzheng Injection (参芪扶正注射液), PHY906, etc. Thus, understanding the novel function of Chinese medicine may allow us to develop a promising therapeutic approach to enhance the effects of anticancer strategies and prevent or overcome their resistance in the treatment of cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Parikh AR, Leshchiner I, Elagina L, Goyal L, Levovitz C, Siravegna G, et al. Liquid versus tissue biopsy for detecting acquired resistance and tumor heterogeneity in gastrointestinal cancers. Nat Med 2019;25:1415–1421.

    Article  CAS  Google Scholar 

  2. Off-target alterations drive resistance to TRK inhibitors in some cancers. Cancer Discov 2019;9:OF7.

  3. Kim SG, Becattini S, Moody TU, Shliaha PV, Littmann ER, Seok R, et al. Microbiota-derived lantibiotic restores resistance against vancomycin-resistant Enterococcus. Nature 2019;572:665–669.

    Article  CAS  Google Scholar 

  4. The Lancet O. Rethinking traditional Chinese medicines for cancer. Lancet Oncol 2015;16:1439.

    Article  Google Scholar 

  5. Efferth T, Li PC, Konkimalla VS, Kaina B. From traditional Chinese medicine to rational cancer therapy. Trends Mol Med 2007;13:353–361.

    Article  CAS  Google Scholar 

  6. Luo C, Xu X, Wei X, Feng W, Huang H, Liu H, et al. Natural medicines for the treatment of fatigue: bioactive components, pharmacology, and mechanisms. Pharmacol Res 2019;148:104409.

    Article  CAS  Google Scholar 

  7. Liu YX, Bai JX, Li T, Fu XQ, Guo H, Zhu PL, et al. A TCM formula comprising Sophorae Flos and Lonicerae Japonicae Flos alters compositions of immune cells and molecules of the STAT3 pathway in melanoma microenvironment. Pharmacol Res 2019;142:115–126.

    Article  CAS  Google Scholar 

  8. Jiao L, Xu J, Sun J, Chen Z, Gong Y, Bi L, et al. Chinese herbal medicine combined with EGFR-TKI in EGFR mutation-positive advanced pulmonary adenocarcinoma (CATLA): a multicenter, randomized, double-blind, placebocontrolled trial. Front Pharmacol 2019;10:732.

    Article  CAS  Google Scholar 

  9. Wei C, Yao X, Jiang Z, Wang Y, Zhang D, Chen X, et al. Cordycepin inhibits drug-resistance non-small cell lung cancer progression by activating AMPK signaling pathway. Pharmacol Res 2019;144:79–89.

    Article  CAS  Google Scholar 

  10. Lu JJ, Dang YY, Huang M, Xu WS, Chen XP, Wang YT. Anti-cancer properties of terpenoids isolated from Rhizoma curcumae—a review. J Ethnopharmacol 2012;143:406–411.

    Article  CAS  Google Scholar 

  11. Aggarwal BB, Yuan W, Li S, Gupta SC. Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: identification of novel components of turmeric. Mol Nutr Food Res 2013;57:1529–1542.

    Article  CAS  Google Scholar 

  12. An YW, Hu G, Yin GP, Zhu JJ, Zhang QW, Wang ZM, et al. Quantitative analysis and discrimination of steamed and non-steamed rhizomes of Curcuma wenyujin by GC-MS and HPLC. J Chromatogr Sci 2014;52:961–970.

    Article  CAS  Google Scholar 

  13. Zhai B, Zeng Y, Zeng Z, Zhang N, Li C, Zeng Y, et al. Drug delivery systems for elemene, its main active ingredient beta-elemene, and its derivatives in cancer therapy. Int J Nanomedicine 2018;13:6279–6296.

    Article  CAS  Google Scholar 

  14. Zhai B, Zhang N, Han X, Li Q, Zhang M, Chen X, et al. Molecular targets of beta-elemene, a herbal extract used in traditional Chinese medicine, and its potential role in cancer therapy: a review. Biomed Pharmacother 2019;114:108812.

    Article  CAS  Google Scholar 

  15. Wang X, Liu Z, Sui X, Wu Q, Wang J, Xu C. Elemene Injection as adjunctive treatment to platinum-based chemotherapy in patients with stage III/IV non-small cell lung cancer: a meta-analysis following the PRISMA guidelines. Phytomedicine 2019;59:152787.

    Article  CAS  Google Scholar 

  16. Xu XW, Yuan ZZ, Hu WH, Wang XK. Meta-analysis on Elemene Injection combined with cisplatin chemotherapeutics in treatment of non-small cell lung cancer. Chin J Chin Mater Med (Chin) 2013;38:1430–1437.

    CAS  Google Scholar 

  17. Cheng H, Ge X, Zhuo S, Gao Y, Zhu B, Zhang J, et al. Beta-elemene synergizes with gefitinib to inhibit stemlike phenotypes and progression of lung cancer via downregulating EZH2. Front Pharmacol 2018;9:1413.

    Article  CAS  Google Scholar 

  18. Zhou K, Wang L, Cheng R, Liu X, Mao S, Yan Y. Elemene increases autophagic apoptosis and drug sensitivity in human cisplatin (DDP)-resistant lung cancer cell line SPC-A-1/DDP by inducing beclin-1 expression. Oncol Res 2017; May 23 [Epub ahead of print].

    Google Scholar 

  19. Lin L, Li L, Chen X, Zeng B, Lin T. Preliminary evaluation of the potential role of beta-elemene in reversing erlotinibresistant human NSCLC A549/ER cells. Oncol Lett 2018;16:3380–3388.

    PubMed  PubMed Central  Google Scholar 

  20. Guo Z, Liu Z, Yue H, Wang J. Beta-elemene increases chemosensitivity to 5-fluorouracil through down-regulating microRNA-191 expression in colorectal carcinoma cells. J Cell Biochem 2018;119:7032–7039.

    Article  CAS  Google Scholar 

  21. Huang C, Yu Y. Synergistic cytotoxicity of beta-elemene and cisplatin in gingival squamous cell carcinoma by inhibition of STAT3 signaling pathway. Med Sci Monit 2017;23:1507–1513.

    Article  CAS  Google Scholar 

  22. Mu L, Wang T, Chen Y, Tang X, Yuan Y, Zhao Y. Betaelemene enhances the efficacy of gefitinib on glioblastoma multiforme cells through the inhibition of the EGFR signaling pathway. Int J Oncol 2016;49:1427–1436.

    Article  CAS  Google Scholar 

  23. Zhang J, Zhang HD, Yao YF, Zhong SL, Zhao JH, Tang JH. Beta-elemene reverses chemoresistance of breast cancer cells by reducing resistance transmission via exosomes. Cell Physiol Biochem 2015;36:2274–2286.

    Article  CAS  Google Scholar 

  24. Zhang J, Zhang H, Chen L, Sun DW, Mao CF, Chen W, et al. Beta-elemene reverses chemoresistance of breast cancer via regulating MDR-related microRNA expression. Cell Physiol Biochem 2014;34:2027–2037.

    Article  CAS  Google Scholar 

  25. Aggarwal BB, Sundaram C, Malani N, Ichikawa H. Curcumin: the Indian solid gold. Adv Exp Med Biol 2007;595:1–75.

    Article  Google Scholar 

  26. Landis-Piwowar KR, Milacic V, Chen D, Yang H, Zhao Y, Chan TH, et al. The proteasome as a potential target for novel anticancer drugs and chemosensitizers. Drug Resist Updat 2006;9:263–273.

    Article  CAS  Google Scholar 

  27. Chen P, Huang HP, Wang Y, Jin J, long WG, Chen K, et al. Curcumin overcome primary gefitinib resistance in nonsmall-cell lung cancer cells through inducing autophagyrelated cell death. J Exp Clin Cancer Res 2019;38:254.

    Article  Google Scholar 

  28. Zhang P, Lai ZL, Chen HF, Zhang M, Wang A, Jia T, et al. Curcumin synergizes with 5-fluorouracil by impairing AMPK/ULK1-dependent autophagy, AKT activity and enhancing apoptosis in colon cancer cells with tumor growth inhibition in xenograft mice. J Exp Clin Cancer Res 2017;36:190.

    Article  CAS  Google Scholar 

  29. Roy M, Mukherjee S. Reversal of resistance towards cisplatin by curcumin in cervical cancer cells. Asian Pac J Cancer Prev 2014;15:1403–1410.

    Article  Google Scholar 

  30. Sandur SK, Deorukhkar A, Pandey MK, Pabón AM, Shentu S, Guha S, et al. Curcumin modulates the radiosensitivity of colorectal cancer cells by suppressing constitutive and inducible NF-kappaB activity. Int J Radiat Oncol Biol Phys 2009;75:534–542.

    Article  CAS  Google Scholar 

  31. Kunnumakkara AB, Guha S, Krishnan S, Diagaradjane P, Gelovani J, Aggarwal BB. Curcumin potentiates antitumor activity of gemcitabine in an orthotopic model of pancreatic cancer through suppression of proliferation, angiogenesis, and inhibition of nuclear factor-kappaB-regulated gene products. Cancer Res 2007;67:3853–3861.

    Article  CAS  Google Scholar 

  32. Hu Y, Lu W, Chen G, Zhang H, Jia Y, Wei Y, et al. Overcoming resistance to histone deacetylase inhibitors in human leukemia with the redox modulating compound betaphenylethyl isothiocyanate. Blood 2010;116:2732–2741.

    Article  CAS  Google Scholar 

  33. Hasegawa H, Yamada Y, Komiyama K, Hayashi M, Ishibashi M, Sunazuka T, et al. A novel natural compound, a cycloanthranilylproline derivative (Fuligocandin B), sensitizes leukemia cells to apoptosis induced by tumor necrosis factor related apoptosis-inducing ligand (TRAIL) through 15-deoxy-delta 12, 14 prostaglandin J2 production. Blood 2007;110:1664–1674.

    Article  CAS  Google Scholar 

  34. Dong J, Su SY, Wang MY, Zhan Z. Shenqi Fuzheng, an injection concocted from Chinese medicinal herbs, combined with platinum-based chemotherapy for advanced non-small cell lung cancer: a systematic review. J Exp Clin Cancer Res 2010;29:137.

    Article  Google Scholar 

  35. Li S, Xu J, Yao Z, Hu L, Qin Z, Gao H, et al. The roles of breast cancer resistance protein (BCRP/ABCG2) and multidrug resistance-associated proteins (MRPs/ABCCs) in the excretion of cycloicaritin-3-O-glucoronide in UGT1A1-overexpressing HeLa cells. Chem Biol Interact 2018;296:45–56.

    Article  CAS  Google Scholar 

  36. Wu L, Cao KX, Ni ZH, Li WD, Chen ZP, Chang HB, et al. Effects of Dahuang Zhechong Pill on doxorubicin-resistant SMMC-7721 xenografts in mice. J Ethnopharmacol 2018;222:71–78.

    Article  Google Scholar 

  37. Lam W, Jiang Z, Guan F, Huang X, Hu R, Wang J, et al. PHY906(KD018), an adjuvant based on a 1800-year-old Chinese medicine, enhanced the anti-tumor activity of Sorafenib by changing the tumor microenvironment. Sci Rep 2015;5:9384.

    Article  CAS  Google Scholar 

  38. Pan B, Cheng T, Nan KJ, Qiu GQ, Sun XC. Effect of Fuzheng Yiliu Decoction combined with chemotherapy on patients with intermediate and late stage gastrointestinal cancer. World J Gastroenterol 2005;11:439–442.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tian Xie.

Ethics declarations

The authors declare no conflict of interest. None of the contents of this manuscript has been previously published or is under consideration elsewhere. All the authors read and approved the final version of the manuscript prior to submission.

Additional information

Supported by the National Natural Science Foundation of China (No. 81672932, 81730108, 81874380 and 81973635), Zhejiang Provincial Natural Science Foundation of China for Distinguished Young Scholars (No. LR18H160001), Zhejiang Province Science and Technology Project of TCM (No. 2019ZZ016), Zhejiang Province Medical Science and Technology Project (No. 2017RC007), Talent Project of Zhejiang Association for Science and Technology (No. 2017YCGC002), Key Project of Hangzhou Ministry of Science and Technology (No. 20162013A07)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sui, Xb., Xie, T. Combination of Chinese and Western Medicine to Prevent and Reverse Resistance of Cancer Cells to Anticancer Drugs. Chin. J. Integr. Med. 26, 251–255 (2020). https://doi.org/10.1007/s11655-019-3180-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-019-3180-x

Keywords

Navigation