Pharmacogenetic-Based Interactions between Nutraceuticals and Angiogenesis Inhibitors

Raffaele Di Francia, Massimiliano Berretta, Giulio Benincasa, Alfredo D'Avino, Sergio Facchini, Domenico Costagliola, Paola Rossi

Research output: Contribution to journalArticlepeer-review


Background: Angiogenesis inhibitors (AIs) have become established as an effective cancer treatment. Whereas their interactions with antineoplastic drugs have extensively been investigated, little is known of the effect of their co-administration with nutraceuticals/dietary supplements (N/DSs), which are often self-prescribed. N/DSs comprise a wide range of products such as herbs, nutrients, vitamins, minerals, and probiotics. Assessment of their interactions with cancer drugs, particularly AIs, is hampered by the difficulty of gauging the amount of active substances patients actually take. Moreover, there is no agreement on which approach should be used to determine which N/DSs are most likely to influence AI treatment efficacy. We present a comprehensive review of the metabolic routes of the major AIs and their possible interactions with N/DSs. Methods: The PubMed and Cochrane databases were searched for papers describing the metabolic routes of the main AIs and N/DSs. Results: Data from the 133 studies thus identified were used to compile a diagnostic table reporting known and expected AI-N/DS interactions based on their metabolization pathways. AIs and N/DSs sharing the cytochrome P450 pathway are at risk of negative interactions. Conclusions: Recent advances in pharmacogenetics offer exceptional opportunities to identify prognostic and predictive markers to enhance the efficacy of individualized AI treatments. The table provides a guide to genotyping patients who are due to receive AIs and is a promising tool to prevent occult AI-N/DS interactions in poor metabolizers. N/DS use by cancer patients receiving AIs is a topical problem requiring urgent attention from the scientific community.
Original languageEnglish
Article number522
Number of pages14
Issue number6
Publication statusPublished - May 30 2019


  • *complementary and alternative medicines (CAMs)
  • *cytochrome P450 polymorphisms
  • *dietary supplements
  • *neoangiogenesis
  • *nutraceuticals
  • *pharmacogenomics
  • *targeted treatment
  • Angiogenesis Inhibitors/*pharmacology/therapeutic use
  • Animals
  • *Dietary Supplements
  • *Drug Interactions
  • Humans
  • Neovascularization, Pathologic/drug therapy/physiopathology
  • *Pharmacogenetics
  • Vascular Endothelial Growth Factor A/genetics


Dive into the research topics of 'Pharmacogenetic-Based Interactions between Nutraceuticals and Angiogenesis Inhibitors'. Together they form a unique fingerprint.

Cite this