Can Curcumin Supplement be Taken Along with Tamoxifen by Breast Cancer Patients?
Curcumin is the key active ingredient of the common spice Turmeric. Piperine, the key ingredient of Black pepper is often included in Curcumin formulations to improve its bioavailability.
Many breast cancer patients are treated with a standard of care hormonal therapy called Tamoxifen. Along with such standard of care treatments, breast cancer patients often tend to look out for natural supplements like Curcumin (from Turmeric) with strong anti-inflammatory, antioxidant and anti-cancer properties to either improve their immunity, treatment efficacy, quality of life or reduce treatment side-effects. However, some of these supplements can end up harming the treatment.
The oral drug Tamoxifen is metabolized in the body into its pharmacologically active metabolites through the cytochrome P450 enzymes in the liver. Endoxifen is the clinically active metabolite of Tamoxifen, that is the key mediator of efficacy of tamoxifen therapy (Del Re M et al, Pharmacol Res., 2016). Some earlier studies done on rats had shown that there is a drug-drug interaction between Curcumin (from Turmeric) and Tamoxifen because Curcumin inhibited the cytochrome P450 mediated metabolism of tamoxifen conversion to its active form (Cho YA et al, Pharmazie, 2012). A recently published prospective clinical study (EudraCT 2016-004008-71/NTR6149) from the Erasmus MC Cancer Institute in the Netherlands, tested this interaction between Curcumin and Tamoxifen in breast cancer patients (Hussaarts KGAM et al, Cancers (Basel), 2019).
In this study they tested the effect of Curcumin alone and Curcumin with its bio-enhancer Piperine when taken concurrently with Tamoxifen in 16 evaluable breast cancer patients. Patients were given Tamoxifen for 28 days prior to the study to ensure steady-state levels of Tamoxifen in all the subjects. Patients were then administered 3 cycles in 2 randomly segregated groups with different sequence of the cycles. Tamoxifen was given at a constant dose of 20-30 mg during the 3 cycles. The 3 cycles included Tamoxifen alone, Tamoxifen with 1200 mg Curcumin taken three times daily, or Tamoxifen with 1200 mg Curcumin and 10 mg Piperine taken three times daily. Levels of Tamoxifen and Endoxifen were compared with and without Curcumin alone and with the addition of the bio-enhancer Piperine.
This study indicated that the concentration of the active metabolite Endoxifen decreased with Curcumin and further decreased with Curcumin and Piperine taken together. This decrease in Endoxifen was statistically significant.
|Tags:NewsEvidence Based ResearchCancerBreast Cancer|