title: Natural Anti-Cancer Agents: Implications in Gemcitabine-Resistant Pancreatic Cancer Treatment.
abstract: OBJECTIVE
  Pancreatic cancer is one of the most lethal malignancies accounting for the fourth leading cause of cancer-related deaths in the United States. Among several explored anticancer agents, Gemcitabine, a nucleoside analogue remained a front line chemotherapeutic agent for the treatment of pancreatic cancer. However, gemcitabine exerts a low response rate with limited progression free survival in patients due to cellular resistance of pancreatic tumors to this therapy. Several chemotherapeutic agents have been explored in combination with gemcitabine against pancreatic cancer with overall mixed responses and survival rates. Naturally occurring dietary agents possess promising anticancer properties and have been shown to target various oncogenic signaling pathways in in-vitro and in-vivo pancreatic cancer models.
  
  
  RESULTS
  Multiple studies using natural compounds have shown increased therapeutic efficacy of gemcitabine in pancreatic cancer models.
  
  
  CONCLUSIONS
  This review is focused on recent updates on cellular, preclinical and clinical studies utilizing natural anticancer agents with gemcitabine against pancreatic cancer.
authors.affiliation: 1Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH. United States.
authors.forename: Bishal
authors.initials: B
authors.lastname: Marasini
authors.affiliation: Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435-0001. United States.
authors.forename: Ravi P
authors.initials: RP
authors.lastname: Sahu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003474:Curcumin / Q000627:therapeutic use; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D006801:Humans; D010190:Pancreatic Neoplasms / Q000178:diet therapy / Q000188:drug therapy*; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D001688:Biological Products; D003841:Deoxycytidine; D003474:Curcumin; D000093542:Gemcitabine
keywords: Combination therapy for pancreatic cancer; diabetes; gemcitabine; jaundice; natural anti-cancer agents; pancreatic
  cancer