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New Indian Journal of Surgery

Volume  2, Issue 2, April-june 2011, Pages 93-93
 

Review Article

A Randomized Controlled Trial to assess the role of Curcumin in patients receiving neo-adjuvant chemotherapy for breast cancer

Krishna Adit Agarwal

Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi

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Abstract

Curcumin is a natural yellow-pigmented polyphenol component of the spice turmeric, which is derived from the roots of the plant Curcuma longa plant, indigenous to Southeast Asia. The coloring & flavoring properties of Curcumin (difeuloyl methane) have led to its wide use as a dietary additive in a variety of foods. Extracts containing Curcumin have also been used in traditional Indian medicines for generations & have been useful in treatment of inflammation, skin wounds, cough, coryza & certain tumors. Curcuminoids inhibit the generation & propagation of free radicals and act as an antioxidant, inhibiting lipid peroxidation and oxidative DNA damage . The anti-inflammatory property of Curcuminoids have been attributed to the inhibition of lipo-oxygenase and cyclooxygenase resulting in decreased arachidonic acid release and metabolism, along with the property to inhibit activation of NF-B . The role of Curcumin has been studied extensively in breast cancer lines, where it has been able to induce cell cycle arrest & apoptosis by inhibiting cyclin-dependent kinase (cdk) activity, suppressing cyclin D1 and cyclin E expression, increasing levels of cdk inhibitors p21 and p27, and inducing p53 transcriptional activity. Majority of Curcumin’s effects have been attributed to its ability to inhibit transcriptional activity of nuclear factor kappa B (NF-kB), leading to reduced expression of anti-apoptotic, proliferative, pro-angiogenic, and metastatic target genes of NF-kB, with subsequent inhibition of mammary tumorigenesis and metastasis in vivo. Importantly, apoptosis in response to Curcumin appears to be far more pronounced in cancer cell lines versus non-tumorigenic breast epithelial cells. With this background a prospective randomized control trial is being contemplated to assess the role of Curcumin in altering the response to NACT in patients with locally advanced breast carcinoma. 


Corresponding Author : Krishna Adit Agarwal