Volume : 13, Issue : 04, April – 2026

Title:

COMBINATION THERAPY OF NATURAL PRODUCTS WITH STANDARD DRUGS LIKE DOXORUBICIN

Authors :

Sarswati Dhanaji Dethe, Sankalp Tanaji Gavali, Ankit Shankar Ghodake, Alpesh Ankush Chavan, Dr. Rahul Ishwara Jadhav

Abstract :

Cancer remains a leading cause of global morbidity and mortality, and despite significant advances in chemotherapy, the effectiveness of conventional anticancer agents is often limited by severe toxicity and the development of drug resistance. Doxorubicin is one of the most widely used chemotherapeutic agents; however, its clinical utility is restricted due to dose-dependent cardiotoxicity and multidrug resistance. In recent years, the combination of natural products with standard chemotherapeutic drugs has emerged as a promising strategy to overcome these limitations.
Natural compounds such as Curcumin, Resveratrol, Quercetin, Epigallocatechin gallate, and Berberine have demonstrated significant potential in enhancing the therapeutic efficacy of doxorubicin. These phytochemicals exert synergistic effects through multiple mechanisms, including induction of apoptosis, inhibition of drug efflux transporters, modulation of reactive oxygen species, suppression of survival signaling pathways, and inhibition of angiogenesis.
The combination approach not only enhances anticancer activity but also reduces toxicity and improves patient outcomes by enabling dose reduction and protecting normal tissues. Furthermore, advances in nanotechnology-based delivery systems have further improved the bioavailability and targeted delivery of these combinations. This review highlights the mechanistic insights, therapeutic benefits, and current research progress in combining natural products with doxorubicin, emphasizing its potential as an effective strategy in cancer treatment. However, further clinical studies are required to validate these findings and facilitate their translation into clinical practice.
KEYWORDS: Doxorubicin, Natural products, Combination therapy, Phytochemicals, Chemoresistance, Apoptosis, Multidrug resistance, Anticancer activity, Synergistic effect etc.

Cite This Article:

Please cite this article in press Alpesh Ankush Chavan et al., Combination Therapy Of Natural Products With Standard Drugs Like Doxorubicin., Indo Am. J. P. Sci, 2026; 13(04).

REFERENCES:

1. Minotti G, Menna P, Salvatorelli E, Cairo G, Gianni L. Anthracyclines: molecular advances and pharmacologic developments in anticancer therapy. Pharmacol Rev. 2004;56(2):185–229.
2. Carvalho C, Santos RX, Cardoso S, et al. Doxorubicin: the good, the bad and the ugly effect. Curr Med Chem. 2009;16(25):3267–85.
3. Tacar O, Sriamornsak P, Dass CR. Doxorubicin: an update on anticancer mechanisms. J Pharm Pharmacol. 2013;65(2):157–70.
4. Octavia Y, Tocchetti CG, Gabrielson KL, et al. Doxorubicin-induced cardiomyopathy. J Mol Cell Cardiol. 2012;52(6):1213–25.
5. Chatterjee K, Zhang J, Honbo N, Karliner JS. Doxorubicin cardiotoxicity. Cardiology. 2010;115(2):155–62.
6. Newman DJ, Cragg GM. Natural products as sources of new drugs. J Nat Prod. 2020;83(3):770–803.
7. Atanasov AG, Zotchev SB, Dirsch VM, Supuran CT. Natural products in drug discovery. Nat Rev Drug Discov. 2021;20:200–16.
8. Koehn FE, Carter GT. The evolving role of natural products. Nat Rev Drug Discov. 2005;4(3):206–20.
9. Harvey AL, Edrada-Ebel R, Quinn RJ. The re-emergence of natural products. Nat Rev Drug Discov. 2015;14(2):111–29.
10. Aggarwal BB, Kumar A, Bharti AC. Anticancer potential of curcumin. Anticancer Res. 2003;23(1A):363–98.
11. Kunnumakkara AB, Bordoloi D, Harsha C, et al. Curcumin mediates anticancer effects. Br J Pharmacol. 2017;174(11):1325–48.
12. Li Y, Zhang T. Targeting cancer stem cells with curcumin. Cancer Lett. 2014;346(2):197–205.
13. Yang F, Lim GP, Begum AN, et al. Curcumin inhibits oxidative damage. J Biol Chem. 2005;280(7):5892–901.
14. Baur JA, Sinclair DA. Therapeutic potential of resveratrol. Nat Rev Drug Discov. 2006;5(6):493–506.
15. Fulda S, Debatin KM. Sensitization to apoptosis by resveratrol. Oncogene. 2004;23:6702–11.
16. Shukla Y, Singh R. Resveratrol and cellular mechanisms. Ann N Y Acad Sci. 2011;1215:1–8.
17. Boots AW, Haenen GR, Bast A. Health effects of quercetin. Eur J Pharmacol. 2008;585(2-3):325–37.
18. Russo M, Spagnuolo C, Tedesco I, Russo GL. Flavonoids in cancer therapy. Pharmacol Res. 2012;65(4):441–52.
19. Yang CS, Wang X, Lu G, Picinich SC. Cancer prevention by tea. Nat Rev Cancer. 2009;9(6):429–39.
20. Khan N, Mukhtar H. Tea polyphenols in cancer prevention. Life Sci. 2007;81(7):519–33.
21. Tillhon M, Guamán Ortiz LM, Lombardi P, Scovassi AI. Berberine anticancer effects. Biochem Pharmacol. 2012;84(10):1260–7.
22. Liu YT, Hao HP, Xie HG, et al. Pharmacokinetics of berberine. Acta Pharmacol Sin. 2010;31(5):541–50.
23. Gottesman MM. Mechanisms of cancer drug resistance. Annu Rev Med. 2002;53:615–27.
24. Holohan C, Van Schaeybroeck S, Longley DB, Johnston PG. Cancer drug resistance. Nat Rev Cancer. 2013;13(10):714–26.
25. Szakács G, Paterson JK, Ludwig JA, et al. MDR transporters. Nat Rev Drug Discov. 2006;5(3):219–34.
26. Elmore S. Apoptosis: a review. Toxicol Pathol. 2007;35(4):495–516.
27. Trachootham D, Alexandre J, Huang P. ROS in cancer therapy. Nat Rev Drug Discov. 2009;8(7):579–91.
28. Folkman J. Angiogenesis in cancer. Nat Med. 1995;1(1):27–31.
29. Carmeliet P, Jain RK. Angiogenesis in cancer. Nature. 2000;407:249–57.
30. Barenholz Y. Doxil® liposomal doxorubicin. J Control Release. 2012;160(2):117–34.
31. Peer D, Karp JM, Hong S, et al. Nanocarriers in cancer therapy. Nat Nanotechnol. 2007;2:751–60.
32. Torchilin VP. Multifunctional nanocarriers. Nat Rev Drug Discov. 2014;13:813–27.
33. Cragg GM, Pezzuto JM. Natural products in drug discovery. Med Princ Pract. 2016;25(Suppl 2):41–59.
34. Greenwell M, Rahman PKSM. Natural products in drug discovery. Int J Pharm Sci Res. 2015;6:4103–11.
35. Pan MH, Ho CT. Chemopreventive effects of natural compounds. Food Funct. 2011;2:649–58.
36. Anand P, Sundaram C, Jhurani S, et al. Bioavailability of curcumin. Mol Pharm. 2007;4:807–18.
37. Aggarwal BB, Sung B. Pharmacological basis of curcumin. Trends Pharmacol Sci. 2009;30:85–94.
38. Fulda S. Resveratrol in cancer therapy. Biochim Biophys Acta. 2010;1806:55–63.
39. Chen D, Dou QP. Tea polyphenols and cancer. Int J Mol Sci. 2008;9:1196–206.
40. Patwardhan B, Vaidya AD, Chorghade M. Ayurveda and drug discovery. Curr Sci. 2004;86:789–99.
41. Wang S, Meckling KA, Marcone MF, et al. Synergistic anticancer effects. Cancer Lett. 2011;301:103–12.
42. Li-Weber M. Targeting apoptosis pathways. Apoptosis. 2013;18:965–76.
43. Zhang Y, Yang ND, Zhou F, et al. Natural compounds and MDR. Cancer Lett. 2015;365:1–10.
44. Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin. AAPS J. 2013;15:195–218.
45. Shanmugam MK, Rane G, Kanchi MM, et al. Role of natural compounds. Biochem Pharmacol. 2015;97:1–13.