Evidence-based management of herb-drug interaction in cancer chemotherapy

The fact that many cancer patients take herbal medicine, including Chinese herbal medicine, together with chemotherapy is well known. The potential for side effects resulting from concurrent use of these two different treatment modalities requires physicians to be aware of the potential risks and benefits that might arise. This study searched available evidence for herb-drug interaction in cancer therapy and identified 168 articles. Little direct evidence for such interaction could be found, whereas there is some indirect evidence for benefit. Hence, most of the concern about herb-drug interaction in chemotherapy appears to be theoretical. To resolve this discrepancy, evidence-based studies should be undertaken to document the positive and/or negative effects of the concomitant use of herbs with anticancer chemotherapeutic drugs. As evidence accumulates, it would be helpful to set up an internationally accessible database to document the use of Chinese medicine herbs with anticancer drugs. Once this information is collected, efforts should be made to educate health care professionals and patients about the use of Chinese herbal medicine together with Western drugs in treating cancer.