Tocaciu Shreya, Oliver Lesley J, Lowenthal Ray M, Peterson Gregory M, Patel Rahul, Shastri Madhur, McGuinness Georgia, Olesen Inger, Fitton J Helen
1 Royal Hobart Hospital, Hobart, Tasmania, Australia.
2 University of Tasmania, Hobart, Tasmania, Australia.
Integr Cancer Ther. 2018 Mar;17(1):99-105. doi: 10.1177/1534735416684014. Epub 2016 Dec 23.
Although the use of complementary and alternative medicines is widespread in cancer patients, clinical evidence of their benefits is sparse. Furthermore, while they are often assumed to be safe with regard to concurrent use of anticancer therapies, few studies have been carried out to investigate possible interactions. Fucoidans are a group of sulfated carbohydrates, derived from marine brown algae, which have long been used as dietary supplements due to their reported medicinal properties, including anticancer activity. The aim of this study was to investigate the effect of co-administration of fucoidan, derived from Undaria pinnatifida, on the pharmacokinetics of 2 commonly used hormonal therapies, letrozole and tamoxifen, in patients with breast cancer.
This was an open label non-crossover study in patients with active malignancy taking letrozole or tamoxifen (n = 10 for each group). Patients took oral fucoidan, given in the form of Maritech extract, for a 3-week period (500 mg twice daily). Trough plasma concentrations of letrozole, tamoxifen, 4-hydroxytamoxifen, and endoxifen were measured using HPLC-CAD (high-performance liquid chromatography charged aerosol detector), at baseline and after concomitant administration with fucoidan.
No significant changes in steady-state plasma concentrations of letrozole, tamoxifen, or tamoxifen metabolites were detected after co-administration with fucoidan. In addition, no adverse effects of fucoidan were reported, and toxicity monitoring showed no significant differences in all parameters measured over the study period.
Administration of Undaria pinnatifida fucoidan had no significant effect on the steady-state trough concentrations of letrozole or tamoxifen and was well tolerated. These results suggest that fucoidan in the studied form and dosage could be taken concomitantly with letrozole and tamoxifen without the risk of clinically significant interactions.
尽管补充和替代药物在癌症患者中广泛使用，但其益处的临床证据却很少。此外，虽然人们通常认为它们与抗癌疗法同时使用是安全的，但很少有研究调查可能的相互作用。岩藻聚糖是一类硫酸化碳水化合物，源自海洋褐藻，由于其具有包括抗癌活性在内的药用特性，长期以来一直被用作膳食补充剂。本研究的目的是调查源自裙带菜的岩藻聚糖与两种常用激素疗法来曲唑和他莫昔芬联合给药对乳腺癌患者药代动力学的影响。
这是一项针对正在服用来曲唑或他莫昔芬的活动性恶性肿瘤患者的开放标签非交叉研究（每组n = 10）。患者口服以Maritech提取物形式提供的岩藻聚糖，为期3周（每日两次，每次500毫克）。在基线以及与岩藻聚糖联合给药后，使用高效液相色谱-带电气溶胶检测器（HPLC-CAD）测量来曲唑、他莫昔芬、4-羟基他莫昔芬和内昔芬的谷浓度。
与岩藻聚糖联合给药后，未检测到来曲唑、他莫昔芬或他莫昔芬代谢物的稳态血浆浓度有显著变化。此外，未报告岩藻聚糖的不良反应，毒性监测显示在研究期间所有测量参数均无显著差异。
裙带菜岩藻聚糖给药对来曲唑或他莫昔芬的稳态谷浓度无显著影响，且耐受性良好。这些结果表明，所研究形式和剂量的岩藻聚糖可与来曲唑和他莫昔芬同时服用，而无临床显著相互作用的风险。
