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Open AccessReview

Pharmacogenetic-Based Interactions between Nutraceuticals and Angiogenesis Inhibitors

Gruppo Oncologico Ricercatori Italiani GORI, 33100 Pordenone, Italy
Department of Medical Oncology, National Cancer Institute, CRO 33018 Aviano, Italy
Pineta Grande Hospital, 81030 Castel Volturno, Caserta, Italy
Department of Urology, University Federico II of Napoli, 80126 Naples, Italy
Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, 27100 Pavia, Italy
Author to whom correspondence should be addressed.
Academic Editor: Nader Rahimi
Cells 2019, 8(6), 522;
Received: 16 April 2019 / Revised: 20 May 2019 / Accepted: 24 May 2019 / Published: 30 May 2019
(This article belongs to the Special Issue Angiogenesis in Cancer)
Background: Angiogenesis inhibitors (AIs) have become established as an effective cancer treatment. Whereas their interactions with antineoplastic drugs have extensively been investigated, little is known of the effect of their co-administration with nutraceuticals/dietary supplements (N/DSs), which are often self-prescribed. N/DSs comprise a wide range of products such as herbs, nutrients, vitamins, minerals, and probiotics. Assessment of their interactions with cancer drugs, particularly AIs, is hampered by the difficulty of gauging the amount of active substances patients actually take. Moreover, there is no agreement on which approach should be used to determine which N/DSs are most likely to influence AI treatment efficacy. We present a comprehensive review of the metabolic routes of the major AIs and their possible interactions with N/DSs. Methods: The PubMed and Cochrane databases were searched for papers describing the metabolic routes of the main AIs and N/DSs. Results: Data from the 133 studies thus identified were used to compile a diagnostic table reporting known and expected AI-N/DS interactions based on their metabolization pathways. AIs and N/DSs sharing the cytochrome P450 pathway are at risk of negative interactions. Conclusions: Recent advances in pharmacogenetics offer exceptional opportunities to identify prognostic and predictive markers to enhance the efficacy of individualized AI treatments. The table provides a guide to genotyping patients who are due to receive AIs and is a promising tool to prevent occult AI-N/DS interactions in poor metabolizers. N/DS use by cancer patients receiving AIs is a topical problem requiring urgent attention from the scientific community. View Full-Text
Keywords: neoangiogenesis; complementary and alternative medicines (CAMs); targeted treatment; pharmacogenomics; cytochrome P450 polymorphisms; nutraceuticals; dietary supplements neoangiogenesis; complementary and alternative medicines (CAMs); targeted treatment; pharmacogenomics; cytochrome P450 polymorphisms; nutraceuticals; dietary supplements
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Di Francia, R.; Berretta, M.; Benincasa, G.; D’Avino, A.; Facchini, S.; Costagliola, D.; Rossi, P. Pharmacogenetic-Based Interactions between Nutraceuticals and Angiogenesis Inhibitors. Cells 2019, 8, 522.

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