Department of Modern Sciences & Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Infectious Diseases Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Curr Pharm Des. 2019;25(3):333-342. doi: 10.2174/1381612825666190313123704.
Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor. Despite standard multimodality treatment, the highly aggressive nature of GBM makes it one of the deadliest human malignancies. The anti-cancer effects of dietary phytochemicals like curcumin provide new insights to cancer treatment. Evaluation of curcumin's efficacy against different malignancies including glioblastoma has been a motivational research topic and widely studied during the recent decade. In this review, we discuss the recent observations on the potential therapeutic effects of curcumin against glioblastoma. Curcumin can target multiple signaling pathways involved in developing aggressive and drug-resistant features of glioblastoma, including pathways associated with glioma stem cell activity. Notably, combination therapy with curcumin and chemotherapeutics like temozolomide, the GBM standard therapy, as well as radiotherapy has shown synergistic response, highlighting curcumin's chemo- and radio-sensitizing effect. There are also multiple reports for curcumin nanoformulations and targeted forms showing enhanced therapeutic efficacy and passage through blood-brain barrier, as compared with natural curcumin. Furthermore, in vivo studies have revealed significant anti-tumor effects, decreased tumor size and increased survival with no notable evidence of systemic toxicity in treated animals. Finally, a pharmacokinetic study in patients with GBM has shown a detectable intratumoral concentration, thereby suggesting a potential for curcumin to exert its therapeutic effects in the brain. Despite all the evidence in support of curcumin's potential therapeutic efficacy in GBM, clinical reports are still scarce. More studies are needed to determine the effects of combination therapies with curcumin and importantly to investigate the potential for alleviating chemotherapy- and radiotherapy-induced adverse effects.
多形性胶质母细胞瘤（GBM）是最常见的原发性恶性脑肿瘤。尽管采用了标准的多模式治疗，但 GBM 的高度侵袭性使其成为最致命的人类恶性肿瘤之一。膳食植物化学物质如姜黄素的抗癌作用为癌症治疗提供了新的见解。评估姜黄素对不同恶性肿瘤（包括胶质母细胞瘤）的疗效一直是一个激励性的研究课题，并在最近十年中得到了广泛研究。在这篇综述中，我们讨论了姜黄素对胶质母细胞瘤潜在治疗作用的最新观察结果。姜黄素可以针对涉及发展侵袭性和耐药性特征的多个信号通路，包括与神经胶质瘤干细胞活性相关的通路。值得注意的是，与化学疗法药物如替莫唑胺联合治疗、GBM 的标准疗法，以及放射疗法显示出协同反应，突出了姜黄素的化疗和放射增敏作用。也有多项关于姜黄素纳米制剂和靶向制剂的报告显示出增强的治疗效果和通过血脑屏障的能力，与天然姜黄素相比。此外，体内研究表明，用姜黄素治疗的动物没有明显的全身毒性迹象，具有显著的抗肿瘤作用，肿瘤体积减小，存活时间延长。最后，一项在 GBM 患者中的药代动力学研究显示了可检测的肿瘤内浓度，从而表明姜黄素有可能在大脑中发挥其治疗作用。尽管有大量证据支持姜黄素在 GBM 中的潜在治疗效果，但临床报告仍然很少。需要更多的研究来确定姜黄素与其他药物联合治疗的效果，重要的是要研究减轻化疗和放疗引起的不良反应的潜力。
