Ginseng may protect breast cancer patients against doxorubicin-induced cardiac toxicity

Supplementation with ginseng appears to provide protective benefits against early cancer therapeutics-related cardiac dysfunction caused by doxorubicin and may help prevent early decline in left ventricular ejection fraction in patients with breast cancer, suggests a study.

Cancer therapeutics-related cardiac dysfunction referred to a drop in left ventricular ejection fraction (LVEF) of ≥10 percent from baseline.

A team of investigators conducted this randomized, double-blind, placebo-controlled clinical trial in women with nonmetastatic breast cancer whose LVEF was ≥50 percent. Thirty patients were randomly assigned in a 1:1 ratio to receive ginseng (1 g/day; n=15) or placebo (n=15) in addition to chemotherapy.

The investigators performed echocardiographic measurements at baseline, after the fourth and eighth chemotherapy cycles.  They then evaluated the high-sensitive cardiac troponin I at baseline and after the fourth cycle. The primary endpoint was change in LVEF.

LVEF decreased from 62.0 percent to 60.7 percent (difference ‒1.3 percent) in the ginseng group and from 63.27 percent to 58.0 percent (difference ‒5.27 percent) in the control group at the end of the fourth cycle of chemotherapy.

The mean LVEF after the eighth cycle of chemotherapy increased by 0.8 percent from baseline in the intervention group but dropped by ‒7.3 percent in the placebo group (difference, 8.1 percent; p<0.001).

None of the patients in the ginseng group developed cancer therapeutics-related cardiac dysfunction compared to one (6.7 percent; p=0.05) and five (33.3 percent; p=0.02) in the control group after the fourth and eighth cycles, respectively.

No significant between-group differences were observed in high-sensitive cardiac troponin I levels.

“Anthracycline-based chemotherapy increases the risk of cancer therapeutics-related cardiac dysfunction,” the investigators said. “Recently, evidence from in vitro experiments and animal studies have shown that ginsenosides may exert cardiovascular protection against cancer therapeutics-related cardiac dysfunction.”