Synergistic anticancer effect: EGCG+NSAIDs

E. Yiannakopoulou. Medical Laboratories, Faculty of Health and Caring Professions Highest Technological Educational Institute of Athens, Athens, Greece.

Introduction: Recent data have shown strong chemopreventive and possibly cancer chemotherapeutic effects of green tea polyphenols against cancer. On the other hand, epidemiological studies have shown that regular use of non steroidal anti-inflammatory agents (NSAIDs) reduces the risk of development of some cancers. This systematic review aims to synthesize evidence on the possible synergistic anti-cancer effect of green tea catechins with non steroidal anti-inflammatory agents.

Methods: Pubmed, Scopus,Google Scholar, Science Citation Index were searched with the search terms “EGCG”, “green tea catechins” “cancer”, “aspirin”, “salicylates”, “non steroidal anti-inflammmatory agents”, “sulindac”, “ibuprofen”, “celecoxib”, ‘coxibs’, “nimesulide”, “indomethacin”, “carcinogenesis”. The search covered the period from 1966 up to and including October 2016. In vitro or in vivo studies, that investigated the possible synergistic effect of green tea catechins and non steroidal anti-inflammatory agents on suppression of carcinogenesis met inclusion criteria. Investigated outcomes included the effect of co-treatment with green tea catechins and non steroidal anti-inflammatory agents on (i) human cancer cell growth and proliferation (ii) growth of tumors in cancer xenograft models (iii) on human cancer cell migration and invasion (iv) mechanisms of the interaction of green tea catechins with non steroidal anti-inflammatory agents.

Results: Initially seventy one possibly relevant trials were identified and after reviewing the title and abstract, ten experimental studies met inclusion criteria (1). Experimental models included human pancreatic adenocarcinoma cells, human lung cancer cells, human urothelial carcinoma cells, human prostate carcinoma cells and murine models of colon carcinogenesis. Investigated non steroidal anti-inflammatory agents included aspirin, celecoxib, sulindac and ibuprofen. All the data suggest the synergistic interaction of non steroidal anti-inflammatory agents with EGCG in the suppression of carcinogenesis. Although existing evidence on the interaction of these agents is rather limited, their synergistic anticarcinogenic effect has been demonstrated in different experimental models. In addition, no trial has been identified demonstrating no effect or even antagonistic effect of non steroidal anti-inflammatory agents and green tea catechins on the proliferation of human cancer cell lines.

Conclusion: Experimental evidence suggests the synergistic effect of green tea catechins with non steroidal anti-inflammatory agents in the suppression of carcinogenesis with clinical implications in the chemoprevention, adjuvant and metastatic cancer treatment. Given the anticipated favourable safety profile of green tea catechins, and the already applied chemoprevention with non steroidal anti-inflammatory agents, further investigation in the clinical setting seems scientifically justified.

References:

1. Suganuma et al. (2001) J Cancer Res Clin Oncol.127:69-72