Dietary polyphenolic phytochemicals--promising cancer chemopreventive agents in humans? A review of their clinical properties.
Epidemiological and preclinical evidence suggests that polyphenolic phytochemicals exemplified by epigallocatechin gallate from tea, curcumin from curry and soya isoflavones possess cancer chemopreventive properties. Whilst such naturally occurring polyphenols have been the subject of numerous mechanistic studies in cells, information on their clinical properties, which might help assess their promise as human cancer chemopreventive agents, is scarce. Therefore, we present a review of pilot studies and trials with a cancer chemoprevention-related rationale, in which either healthy individuals or patients with premalignant conditions or cancer received polyphenolic phytochemicals. The review identifies trial design elements specifically applicable to polyphenolic phytochemicals. The available evidence for tea polyphenols tentatively supports their advancement into phase III clinical intervention trials aimed at the prevention of progression of prostate intraepithelial neoplasia, leukoplakia or premalignant cervical disease. In the case of curcumin and soya isoflavones more studies in premalignacies seem appropriate to optimise the nature and design of suitable phase III trials. The abundance of flavonoids and related polyphenols in the plant kingdom makes it possible that several hitherto uncharacterised agents with chemopreventive efficacy are still to be identified, which may constitute attractive alternatives to currently used chemopreventive drugs.
Thomasset
Sarah C
SC
Cancer Biomarkers and Prevention Group, Department of Cancer Studies, University of Leicester, Leicester Royal Infirmary, Leicester, UK.
Berry
David P
DP
Garcea
Giuseppe
G
Marczylo
Timothy
T
Steward
William P
WP
Gescher
Andreas J
AJ
D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D002392:Catechin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000737:chemistry / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D003474:Curcumin / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use; D019587:Dietary Supplements; D005419:Flavonoids / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D015394:Molecular Structure; D009369:Neoplasms / Q000517:prevention & control*; D010636:Phenols / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D059808:Polyphenols
D000972:Antineoplastic Agents, Phytogenic; D005419:Flavonoids; D010636:Phenols; D059808:Polyphenols; D002392:Catechin; C045651:epigallocatechin gallate; D003474:Curcumin