Efferth Thomas, Saeed Mohamed E M, Mirghani Elhaj, Alim Awadh, Yassin Zahir, Saeed Elfatih, Khalid Hassan E, Daak Salah
Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany.
Salah Wanasi Foundation for Cancer Research and Control, Khartoum, Sudan.
Oncotarget. 2017 Jul 25;8(30):50284-50304. doi: 10.18632/oncotarget.17466.
Concepts of individualized therapy in the 1970s and 1980s attempted to develop predictive in vitro tests for individual drug responsiveness without reaching clinical routine. Precision medicine attempts to device novel individual cancer therapy strategies. Using bioinformatics, relevant knowledge is extracted from huge data amounts. However, tumor heterogeneity challenges chemotherapy due to genetically and phenotypically different cell subpopulations, which may lead to refractory tumors. Natural products always served as vital resources for cancer therapy (e.g., Vinca alkaloids, camptothecin, paclitaxel, etc.) and are also sources for novel drugs. Targeted drugs developed to specifically address tumor-related proteins represent the basis of precision medicine. Natural products from plants represent excellent resource for targeted therapies. Phytochemicals and herbal mixtures act multi-specifically, i.e. they attack multiple targets at the same time. Network pharmacology facilitates the identification of the complexity of pharmacogenomic networks and new signaling networks that are distorted in tumors. In the present review, we give a conceptual overview, how the problem of drug resistance may be approached by integrating phytochemicals and phytotherapy into academic western medicine. Modern technology platforms (e.g. "-omics" technologies, DNA/RNA sequencing, and network pharmacology) can be applied for diverse treatment modalities such as cytotoxic and targeted chemotherapy as well as phytochemicals and phytotherapy. Thereby, these technologies represent an integrative momentum to merge the best of two worlds: clinical oncology and traditional medicine. In conclusion, the integration of phytochemicals and phytotherapy into cancer precision medicine represents a valuable asset to chemically synthesized chemicals and therapeutic antibodies.
20世纪70年代和80年代的个体化治疗概念试图开发针对个体药物反应性的体外预测测试，但尚未进入临床常规应用。精准医学试图设计新的个体化癌症治疗策略。利用生物信息学，可从海量数据中提取相关知识。然而，肿瘤异质性给化疗带来了挑战，因为存在基因和表型不同的细胞亚群，这可能导致难治性肿瘤。天然产物一直是癌症治疗的重要资源（如长春花生物碱、喜树碱、紫杉醇等），也是新药的来源。开发用于特异性靶向肿瘤相关蛋白的靶向药物是精准医学的基础。植物来源的天然产物是靶向治疗的优质资源。植物化学物质和草药混合物具有多靶点作用，即它们能同时作用于多个靶点。网络药理学有助于识别药物基因组网络和肿瘤中畸变的新信号网络的复杂性。在本综述中，我们给出一个概念性概述，即如何通过将植物化学物质和植物疗法整合到西方医学学术体系中来解决耐药性问题。现代技术平台（如“组学”技术、DNA/RNA测序和网络药理学）可应用于多种治疗方式，如细胞毒性和靶向化疗以及植物化学物质和植物疗法。因此，这些技术代表了一种整合动力，能融合两个领域的优势：临床肿瘤学和传统医学。总之，将植物化学物质和植物疗法整合到癌症精准医学中，对于化学合成药物和治疗性抗体而言是一项宝贵的财富。
