[Frontiers in Bioscience E4, 546-567, January 1, 2012]

Dietary supplements and natural products in breast cancer trials

Karl Kado1, Andrew Forsyth1, Priyesh Ramesh Patel1, Janice Ann Schwartz1,2

1Wayne State University School of Medicine, 540 E. Canfield Detroit, MI 48201, 2Michigan State University College of Osteopathic Medicine, 4707 St. Antoine, Detroit, MI 48201

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Clinical trials
3.1. Trial activity and enrollment
3.2. Trial types and phases
4. Natural health products in current clinical trials
4.1. Vitamins, minerals, and cofactors in breast cancer trials
4.1.1. Vitamin D (cholecalciferol, cacitriol)
4.1.2. Vitamin B6 (pyroxidine)
4.1.3. Vitamin B12 (cobalamin)
4.1.4. Vitamin E (alpha tocopherol)
4.1.5. CoEnzume Q10
4.2. Herbal extracts in breast cancer trials
4.2.1. Mistletoe (viscum album P; iscadorP)
4.2.2. Grapeseed (IHS636)
4.2.3. Green tea (polyphenon E)
4.2.4. Coriolus vesicolor (yunzhi)
4.2.5. Herba scutellaria barbata (BZL101)
4.3. Amino acids and amino acid derivatives in breast cancer trials
4.3.1. Carnitine (acetyl-l-carnitine)
4.3.2. Glutamine
4.4. Fatty acids in breast cancer trials
4.4.1. Omega-3-fatty acids
4.5. Phytochemicals in breast cancer trials
4.5.1. Garlic (allium sativum)
4.5.2. d-Limonene
4.6. Other natural health products currently undergoing trial testing
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5. Complementary and conventional therapy combinations
5.1.Natural health products and chemotherapeutic drugs
5.2. Natural health products and endocrine agents
5.3. Natural health products and radiation therapy
6. Clinical trials testing natural health products in healthy women
7. Summary and perspectives
8. Acknowledgements
9. References

1. ABSTRACT

The association between breast cancer and modifiable health behaviors is well supported. At least one-half of all cancers are suggested to have a dietary component. It is not surprising therefore that many of the dietary agents and natural health products that have attracted the attentions of scientists and practitioners are now moving into clinical trials. In this report, we review 65 clinical intervention trials evaluating over 30 dietary supplements and natural health products for use in breast cancer. The products being tested in these trials fall broadly into the following categories: (i) vitamins, minerals, cofactors; (ii) herbal extracts; (iii) amino acids; (iv) fatty acids; (v) animal products; (vi) probiotics; (vii) phytochemicals; and (viii) combination formulations. Trial outcome measures include risk modification, efficacy testing (with dietary supplements alone or dietary supplementanticancer drug combinations), toxicity reduction, biomarker identification, symptom management, and quality of life parameters. The wide range of interests in natural product testing at the clinical trial level supports the potential utility of these agents in the breast cancer prevention, treatment, and management regimens of the future.