Berberine as an Adjuvant and Sensitizer to Current Chemotherapy

Abstract This chapter discusses the potential chemosensitizing role of the nutraceutical berberine in different cancers when it is combined with commonly used chemotherapeutic drugs. A detailed analysis of in vitro and in vivo studies revealed an additive or a synergistic effect of berberine against known mechanisms involved in the development of resistance in cancer cells. Berberine has shown promising activities against 5-fluorouracil; arsenic trioxide; nitrogen mustard; camptothecin; anti-EGFR agents cetuximab, erlotinib, lapatinib, gefitinib, cisplatin, doxorubicin, paclitaxel, and tamoxifen; and TRAIL. In some cases, berberine also showed a growth stimulatory action due to its hormetic effect. Therefore, to understand the dose-effect relationship and the specific berberine, doses used for the evaluation of its chemosensitizing effect were examined. The collective analysis of these observations demonstrate versatility and efficacy of berberine as a chemosensitizer and an adjuvant in cancer therapy, while further studies that prove the same in clinical trials are awaited.