title: Efficacy and safety of pomegranate medicinal products for cancer.
abstract: Preclinical in vitro and in vivo studies demonstrate potent effects of pomegranate preparations in cancer cell lines and animal models with chemically induced cancers. We have carried out one systematic review of the effectiveness of pomegranate products in the treatment of cancer and another on their safety. The PubMed search provided 162 references for pomegranate and cancer and 122 references for pomegranate and safety/toxicity. We identified 4 clinical studies investigating 3 pomegranate products, of which one was inappropriate because of the low polyphenol content. The evidence of clinical effectiveness was poor because the quality of the studies was poor. Although there is no concern over safety with the doses used in the clinical studies, pomegranate preparations may be harmful by inducing synthetic drug metabolism through activation of liver enzymes. We have analysed various pomegranate products for their content of anthocyanins, punicalagin, and ellagic acid in order to compare them with the benchmark doses from published data. If the amount of coactive constituents is not declared, patients risk not benefiting from the putative pomegranate effects. Moreover, pomegranate end products are affected by many determinants. Their declaration should be incorporated into the regulatory guidance and controlled before pomegranate products enter the market.
authors: Institute of Forensic Medicine, University of Freiburg, Albertstr. 9, 79104 Freiburg, Germany.
authors: Christian
authors: C
authors: Vlachojannis
authors: Institute of Nutrition and Food Sciences, Food Technology and Food Biotechnology, University of Bonn, Römerstraße 164, 53117 Bonn, Germany ; Institut Prof. Dr. Georg Kurz GmbH, Eupener Straße 161, 50933 Köln, Germany.
authors: Benno F
authors: 0000-0002-9877-7066
authors: BF
authors: Zimmermann
authors: Institute of Forensic Medicine, University of Freiburg, Albertstr. 9, 79104 Freiburg, Germany.
authors: Sigrun
authors: 0000-0003-0057-3098
authors: S
authors: Chrubasik-Hausmann