Published online Aug 28, 2022. doi: 10.3748/wjg.v28.i32.4620
Peer-review started: January 10, 2022
First decision: April 16, 2022
Revised: April 26, 2022
Accepted: June 26, 2022
Article in press: June 26, 2022
Published online: August 28, 2022
Processing time: 227 Days and 17.9 Hours
Gemcitabine is the cornerstone for pancreatic cancer but demonstrates adverse effects in patients. Orthosiphon stamineus (O.s) has been traditionally used to treat various diseases. C5OSEW5050ESA (NuvastaticTM) is a proprietary extract of O.s that completed a phase 2/3 clinical study for cancer fatigue in cancer patients with solid tumours receiving chemotherapy.
No study has reported the toxicity profile of C5OSEW5050ESA in a pancreatic tumour animal model either as a stand-alone or in combination with gemcitabine.
To determine the anti-tumour activity and potential toxicity of NuvastaticTM and gemcitabine combination on pancreatic xenograft model.
Human pancreatic cancer cells were injected subcutaneously into athymic nude mice. C5EOSEW5050ESA (200 or 400 mg/kg per day) was administered orally, while gemcitabine (10 mg/kg/ 3 d) was given intraperitoneally either alone or in combination treatment. Histopathological analyses of key organs, tumour tissues, and incidence of lethality were determined.
C5EOSEW5050ESA at 200 mg/kg and gemcitabine combination had no additive antitumor effects compared to a single treatment. A comparably greater response in a reduction in tumour growth via a reduction of Ki-67 protein expression, and a decrease in necrosis was also demonstrated by 400 mg/kg of C5EOSEW5050ESA and gemcitabine combination compared to that of individual agents. No signs of organ toxicities were observed in any treatment group.
The combination of C5EOSEW5050ESA with gemcitabine significantly reduced the pancreatic tumour growth in mice compared to a single treatment. This study provides valuable insights into using C5EOSEW5050ESA as a complementary treatment to gemcitabine for pancreatic cancer.
Findings from this study may provide the basis for product formulation and manufacturing of botanical drugs (NuvastaticTM) to be used as complementary medicine for the treatment of pancreatic cancer patients.