Uncaria tomentosa (Ut)—Adjuvant Treatment for Breast Cancer: Clinical Trial

Monday, 09/07/2012  |   Breast Cancer, Herb or Compound  |  no comments

do Carmo Santos Araújo M, Farias IL, Gutierres J, et al. Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), doi:10.1155/2012/676984

Ut or cat’s claw is a safe and effective adjuvant treatment in reducing adverse chemotherapy effects.
Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut) in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma—Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide), were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer.

Uncaria tomentosa enables the stimulation of the immune system, increasing resistance to diseases when the body is immunosuppressed due to stress, malnutrition, or due to the effect of some medication.Many herbal medicines are used for various purposes, in various combinations (along with allopathic and homeopathic, medicines, etc.) based on historical or personal evidences generally not being associated with any adverse effects [1]. Therefore, this study, through a randomized clinical trial, evaluated the efficacy of Ut as a complementary therapy to chemotherapy.The cytotoxic effect of chemotherapeutic agents is not selective for neoplastic cells, being also harmful to other body cells. Hematopoietic suppression is the major complication limiting dosage of such cytostatic agents; neutropenia and thrombocytopenia are the most frequent ones [2]. Treatment should be discontinued when neutrophil count is below 500 cells/mm3 [3]. Thus, the success of the treatment process depends on the neutrophils content. Prevention of chemotherapy-induced neutropenia should be considered a clinical priority [4]. Once it is known that neutropenia predisposes to serious infections, often resulting in delays in treatment cycles and dose reductions.

Treatment using a daily dose of 300 mg dry Ut extract was effective in reducing the main chemotherapy effect, which is neutropenia. The effects of chemotherapy on blood cells tend to become more pronounced during treatment. However, our results show that in cycle six, which corresponds to the end of chemotherapy, the differences in the leukocytes and neutrophils counts were even more significant, as the group that was supplemented with Ut presented values twice as high of neutrophils when compared to the cancer group (without supplementation). In the group without supplementation, 67.89% of patients had neutropenia. Similarly, there was an increase in activated monocytes, as the activated precursors were common to both strains.Our findings are corroborated by other studies that had already shown that the Ut extract has a stimulating effect on growth and differentiates the CFU-GM from mice bone marrow and spleen, using the model for listeriosis [5]. Increased leukocytes numbers were also detected using Ut aqueous extract for six consecutive weeks in volunteers [6]. The recovery of leukocytes was also observed in mice using a model for chemotherapy-induced leukopenia (Doxorubicin) using Granulocyte Colony-Stimulating Factor (Neupogen) as a positive control [7].

Our group confirmed these results using a model for ifosfamide-induced neutropenia in mice, which caused a severe neutropenia. Bioassays showed that treatment with Ut significantly increased neutrophils counts, and a power of 85.2% was calculated in relation to Filgrastim (rhG-CSF) at the corresponding doses tested (5 and 15 mg/day of Ut, and 3 and 9 mcg/day Filgrastim, resp.) [6]. Through in vitro assays in human hematopoietic stem precursor cells (hHSPCs) obtained from umbilical cord blood (UCB), we reach the conclusion that this effect happened due to proliferation of Forming Units-Granulocyte-Macrophage (CFU-GM) [6].In this study, no differences were observed in lymphocyte counts between groups, either supplemented or not with Ut, over the chemotherapy cycles; however, its counts presented decrease due to chemotherapy when compared to the control group. These differences were not observed in the CD4+ and CD8+ subpopulations.This paper reports the effects of different Uncaria tomentosa extracts. The aqueous extract that has the highest concentration of quinic acid and low concentrations of oxindole alkaloids, being related to immunomodulatory properties is mediated by cytokines such as TNF-

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