Protective effects of ginsenosides in cisplatin-induced kidney injury: A systematic review, meta-analysis

Metal-based molecules in the treatment of cancer: From bench to bedside

Cancer remains one of the leading causes of death in the world, with more than 9 million deaths in 2022, a number that continues to rise. This highlights the urgent need for the development of new drugs, with enhanced antitumor capabilities and fewer side effects. Metal-based drugs have been used in clinical practice since the late 1970s, beginning with the introduction of cisplatin. Later, two additional platinum-based molecules, carboplatin, and oxaliplatin, were introduced, and all three continue to be widely used in the treatment of various cancers. However, despite their significant anticancer activity, the undesirable side effects of these drugs have motivated the scientific community to explore other metal-based complexes with greater anticancer potential and fewer adverse effects. In this context, metals such as ruthenium, copper, gold, zinc, palladium, or iridium, present promising alternatives for the development of new anticancer agents. Unfortunately, although thousands of metal-based drugs have been synthesized and tested both in vitro and in animal models, only a few ruthenium-based drugs have entered clinical trials in recent years. Meanwhile, many other molecules with comparable or even greater anticancer potential have not advanced beyond the laboratory stage. In this review, we will revisit the mechanisms of action and anticancer activities of established platinum-based drugs and explore their use in recent clinical trials. Additionally, we will examine the development of potential new metal-based drugs that could one day contribute to cancer treatment worldwide.

Advances in understanding cisplatin-induced toxicity: Molecular mechanisms and protective strategies

Cisplatin, a widely used chemotherapeutic agent, has proven efficacy against various malignancies. However, its clinical utility is hampered by its dose-limiting toxicities, including nephrotoxicity, ototoxicity, neurotoxicity, and myelosuppression. This review aims to provide a comprehensive overview of cisplatin toxicity, encompassing its underlying mechanisms, risk factors, and emerging therapeutic strategies. The mechanisms of cisplatin toxicity are multifactorial and involve oxidative stress, inflammation, DNA damage, and cellular apoptosis. Various risk factors contribute to the interindividual variability in susceptibility to cisplatin toxicity. The risk of developing cisplatin-induced toxicity could be related to pre-existing conditions, including kidney disease, hearing impairment, neuropathy, impaired liver function, and other comorbidities. Additionally, this review highlights the emerging therapeutic strategies that could be applied to minimize cisplatin-induced toxicities and aid in optimizing cisplatin treatment regimens, improving patient outcomes, and enhancing the overall quality of cancer care.

Cisplatin-based combination therapies: Their efficacy with a focus on ginsenosides co-administration

Cisplatin, a frequently prescribed chemotherapeutic agent, serves as a clinically therapeutic strategy for a broad range of malignancies. Its primary mode of action centers around interference with DNA replication and RNA transcription, thereby inducing apoptosis in cancer cells. Nevertheless, the clinical utility of cisplatin is constrained by its severe adverse effects and the burgeoning problem of drug resistance. Ginsenosides, potent bioactive constituents derived from ginseng, possess an array of biological activities. Recent scientific investigations underscore the substantial amplification of cisplatin's anticancer potency and the mitigation of its harmful side effects when administered concomitantly with ginsenosides. This review aims to explore the underlying mechanisms at play in this combination therapy. Initially, we provide a concise introduction to the cisplatin. Then, we pivot towards illuminating how ginsenosides bolster the anticancer efficacy of cisplatin and counteract cisplatin resistance, culminating in enhanced therapeutic outcomes. Furthermore, we provide an extensive discussion on the reduction of cisplatin-induced toxicity in the kidneys, liver, gastrointestinal tract, nervous system, and ear, accompanied by immune-fortification with ginsenosides. The existing clinical combined use of cisplatin and ginsenosides is also discussed. We propose several recommendations to propel additional research into the mechanisms governing the synergistic use of ginsenosides and cisplatin, thereby furnishing invaluable insights and fostering advancement in combined modality therapy.