Expert on challenges of clinical trials of natural products in prostate cancer

In this video, Channing J. Paller, MD, discusses challenges in translating preclinical results of natural products into successful clinical trials for prostate cancer. She is the senior author of the recent Urologic Oncology paper, “Harnessing nature's therapeutic potential: A review of natural products in prostate cancer management.” Paller is an associate professor of oncology at the Johns Hopkins University School of Medicine, director of Prostate Cancer Clinical Research, and associate director of oncology, Johns Hopkins Clinical Research Network, Baltimore, Maryland.

Transcription:

What are the major challenges in translating the promising preclinical results of natural products into successful clinical trials for prostate cancer?

You know, one of the hardest things we do is realizing that even if it works 9 times out of 10 in cell cultures, in animal models, we can't fully replicate the complexities of the human body, including the metabolism, the immune responses, the cellular interactions. These models, in vitro in the lab, tend to use higher doses of natural products than can be safe or feasibly given to humans or absorbed. And so one of our biggest problems is our mode of delivery and ability to get drug to where it needs to get to. And that is one of the main impressive things that drug companies do, is optimize their drugs as they develop them. And so that is one of the biggest challenges I have, is that I don't get to change the natural product. And the other main issue that I would advise all clinicians, all providers, all patients on is that we need to remember these things are not regulated in the same way that the drug is by the FDA. And so what I'm saying here is one of the most popular natural products in prostate cancer years ago was PC-SPES. This was made up of 8 components, and it worked. Everybody who took it their PSA went down. There was a clinical trial with 32 patients. They all had beautiful PSA responses. It was wonderful. And no one could quite figure out which of the 8 herbs worked best, until they learned that 8 of those 32 patients had blood clots. Little did they know, it was spiked with warfarin, a blood thinner, and DES, an estradiol. So these things ended up causing blood clots when given at an uncontrolled rate. And so what we need to remember is we need to think carefully about what we're putting in our body and what the regulations are about natural products that we ingest. I always say from the plant is better rather than processed things. But we need to be careful when we take these different compounds that we really know what we're getting and it's not confounded by something else.

This transcript was AI generated and edited by human editors for clarity.