SYMPOSIA Saturday, May 27, 10:30-12:30
From Bench to Bedside: Natural Health Products for
Cancer Patients
Speakers: Stephen Sagar, MD, Jacqueline Shan, PhD, DSc,
A Douglas Kinghorn, PhD, DSc, Robert Newman, PhD, Bharat Aggrawal, PhD,
Sandra Miller, PhD, Kara Kelly, MD, Heather Boon, PhD
New therapies are required for cancer prevention,
cancer treatment, and alleviation of symptoms. The design of new drugs,
such as monoclonal antibodies or targeted drug therapies, has led to
important but limited progress. The paradigm of synergistic chemical
modulation of cancer cell physiology is being developed. Plant products
(phytochemicals or botanicals) provide a wealth of complex chemicals
that can biologically modify the response of both cancer cells and normal
host tissues.
There are numerous challenges in developing
these products for clinical application. This symposium aims to evaluate
the challenges from the perspectives of the laboratory researcher, the
clinical scientist, and industry. Important issues include screening
of potential natural health products and evaluating their potential
efficacy in the laboratory. Quality assurance and the establishing of
consistency of a natural health product are made difficult by the complexity
of ingredients and variability of the source of the raw herbs. New techniques
to measure chemical and biological activity are being utilized. Phase
I, II, and III clinical trials are necessary to determine appropriate
dose, toxicity, potential efficacy, and proven efficacy when compared
to placebo or current standard therapy. In view of the complexity of
herbal products, these trials may present their own unique challenges
compared to the standard pharmaceutical model. Clinical research requires
an application to a government regulatory body (such as the FDA or NHPD)
prior to the study being implemented. Further requirements are necessary
prior to marketing.
We will discuss the new higher standards being
applied to natural health products to establish their quality, efficacy
and safety. We will discuss potential biological response modifiers,
such as curcumin (turmuric) and proanthocyanidins (grape seed extract)
that may prevent cancer development and restrain progression. In addition,
these products can also reduce toxicity of anticancer therapies, such
as radiotherapy and chemotherapy. Many botanicals may prevent cancer
progression by antagonism of the COX-2 enzyme, induction of apoptosis
or by inhibiting new blood vessel formation. Other phytochemicals, such
as astragalus and maitake mushroom can influence cell mediated immunity
and cytokine production. Herbs used in traditional Chinese medicine
are a rich source for these products. Phytochemicals can reduce the
side effects from conventional therapies. The herb, silymarin (milk
thistle) may reduce liver toxicity from chemotherapy. Other natural
health products may alleviate symptoms, for example Traumeel for chemotherapy-induced
stomatitis. Black cohosh can reduce sweats and hot flashes, and ginseng
may reduce fatigue. Refined derivatives of natural health products may
be more consistent in quality and potency, allowing more reliable clinical
studies to be completed. For example, CVT-E002 (Cold-FX) is a polysaccharide
derivative from North American ginseng that has been standardized in
the laboratory and demonstrated, through clinical trials, to increase
immunity and reduce the symptoms and development of colds and influenza.
The symposium will bring together laboratory
scientists, pharmacists, health services experts, clinicians, and a
representative from industry, in order to encourage a seamless process
of bringing effective natural health products from the laboratory to
the clinic.
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