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When Nature Meets Oncology: Unraveling Herb–Drug Interactions in Cancer Therapy

Summary

Many cancer patients use herbal supplements and natural products alongside their cancer treatments without telling their doctors, which can be dangerous. Some natural products like St. John’s Wort and grapefruit juice significantly alter how the body processes cancer medications, potentially making treatments ineffective or toxic. The review provides guidance on which natural products are safe to use with cancer therapy and which should be avoided completely, emphasizing the importance of open communication between patients and healthcare providers.

Background

Natural product use by cancer patients alongside conventional therapies is widespread globally, with 22-46% of oncology patients using herbal medicines and supplements. Most patients do not disclose this use to healthcare providers, creating hidden safety risks given the narrow therapeutic window of anticancer drugs.

Objective

To summarize current clinical evidence on interactions between widely used natural products and modern cancer treatments including chemotherapy, targeted therapy, and immunotherapy, with emphasis on pharmacokinetic and pharmacodynamic mechanisms and their real-world clinical implications.

Results

St. John’s wort showed strong clinical evidence of dangerous interactions through CYP3A4 induction, reducing irinotecan exposure by 42%. Grapefruit juice, ginseng, curcumin, and green tea demonstrated clinically significant pharmacokinetic or pharmacodynamic interactions with chemotherapy and targeted therapies. Emerging evidence suggests natural products may modulate immune checkpoint pathways relevant to immunotherapy.

Conclusion

Natural products are biologically active compounds capable of profound interactions with anticancer drugs. The field requires proactive patient communication, structured risk-stratification frameworks, well-designed clinical trials, and real-world pharmacovigilance data to bridge the gap between mechanistic knowledge and clinical practice.
  • Published in:International Journal of Molecular Sciences,
  • Study Type:Review,
  • Source: PMID: 41226533, DOI: 10.3390/ijms262110494
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