The Effects of Simvastatin and Soursop (Annona muricata) Leaf Extract on Colorectal Cancer

A Systematic Review

  • Ignatia Ceraphine Amadea Alumni Indonesia International Institute for Life Science
  • Dina Atrasina Indonesia International Institute for Life Sciences
Keywords: Colorectal Cancer, Simvastatin, Soursop, Anticancer Agents, Combination Drug Therapy

Abstract

Colorectal cancer (CRC) is a heterogeneous disease of the colon and rectum. In Indonesia, CRC has the fourth highest cancer incidence, with about 30,000 new cases and causing around 16,000 deaths per year. Numerous studies have shown the benefits of using simvastatin and Annona muricata (A. muricata) leaf extract to promote cytotoxic effects in CRC cells. This systematic review aimed to evaluate the effects and the possible molecular mechanisms of actions used by simvastatin and A. muricata leaf extract to exert anti-cancer effects in CRC cells. We synthesized published studies on the effect of simvastatin and A. muricata leaf extract in in vitro and in vivo CRC studies, and highlighted the potential application of simvastatin and A. muricata leaf extract in combination with other anti-cancer treatments. This systematic review was written in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Simvastatin and A. muricata leaf extract were shown to suppress CRC cell growth and proliferation and generate a synergistic effect when combined with other anti-cancer treatments. Several possible mechanisms of actions of simvastatin include bone morphogenetic protein (BMP) pathway and mevalonate pathway activation, ERKs inactivation, and regulation of the yes-associated protein 1 (YAP1), while for A. muricata leaf extract, possible mechanisms of actions include intrinsic apoptosis pathway activation, cytochrome c-mediated apoptosis, mitochondria-mediated apoptosis, and programmed cell death initiation. Further experimental evidence is needed to determine the specific mechanisms on how simvastatin and A. muricata leaf extract induce anti-cancer effects against CRC cells.

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Author Biographies

Ignatia Ceraphine Amadea, Alumni Indonesia International Institute for Life Science

Biomedicine, I3L, Jakarta, Indonesia

Dina Atrasina, Indonesia International Institute for Life Sciences

Biomedicine Department, Indonesia International Institute for Life Sciences, Jakarta, Indonesia

References

Abdullah, M., Desmarini, D., Meilaini, S., Sari, P., Yunaini, L., & Fadilah, F. (2019). The effect of ethanolic leaves extract of soursop (Annona muricata L.) on human colorectal cancer cell line: cell viability and in silico study to cyclin D1 protein. Health Science Journal of Indonesia, 10(2), 96-102.
Abdullah, M., Sudoyo, A. W., Utomo, A. R., Fauzi, A., & Rani, A. A. (2012). Molecular profile of colorectal cancer in Indonesia: is there another pathway?. Gastroenterology and Hepatology from bed to bench, 5(2), 71.
Awad, M. G., Ali, R. A., Abd El-Monem, D. D., & El-Magd, M. A. (2020). Graviola leaves extract enhances the anti-cancer effect of cisplatin on various cancer cell lines. Molecular & Cellular Toxicology, 1-15.
Baas, J. M., Krens, L. L., Bos, M. M., Portielje, J. E., Batman, E., van Wezel, T., ... & Gelderblom, H. (2015a). Safety and efficacy of the addition of simvastatin to panitumumab in previously treated KRAS mutant metastatic colorectal cancer patients. Anti-cancer drugs, 26(8), 872-877.
Baas, J. M., Krens, L. L., Ten Tije, A. J., Erdkamp, F., van Wezel, T., Morreau, H., ... & Guchelaar, H. J. (2015b). Safety and efficacy of the addition of simvastatin to cetuximab in previously treated KRAS mutant metastatic colorectal cancer patients. Investigational New Drugs, 33(6), 1242-1247.
Beckwitt, C. H., Shiraha, K., & Wells, A. (2018). Lipophilic statins limit cancer cell growth and survival, via involvement of Akt signaling. PLoS One, 13(5). Cassé, C. (2018). Molecular mechanisms of Annona muricata anti-proliferative/anti-cancer properties. Biomed Genet Genomics. Volume 4(1): 1-4
Chang, H. L., Chen, C. Y., Hsu, Y. F., Kuo, W. S., Ou, G., Chiu, P. T., ... & Hsu, M. J. (2013). Simvastatin induced HCT116 colorectal cancer cell apoptosis through p38MAPK-p53-survivin signaling cascade. Biochimica et Biophysica Acta (BBA)-General Subjects, 1830(8), 4053-4064. Chen, M. J., Cheng, A. C., Lee, M. F., & Hsu, Y. C. (2018). Simvastatin induces G1 arrest by up‐regulating GSK3β and down‐regulating CDK4/cyclin D1 and CDK2/cyclin E1 in human primary colorectal cancer cells. Journal of Cellular Physiology, 233(6), 4618-4625. Cho, S. J., Kim, J. S., Kim, J. M., Lee, J. Y., Jung, H. C., & Song, I. S. (2008). Simvastatin induces apoptosis in human colon cancer cells and in tumor xenografts, and attenuates colitis‐associated colon cancer in mice. International journal of cancer, 123(4), 951-957. Chu, E. (2007). Clinical colorectal cancer: "ode to 5-fluorouracil". Clinical colorectal cancer, 6(9), 609. Colussi, D., Brandi, G., Bazzoli, F., & Ricciardiello, L. (2013). Molecular pathways involved in colorectal cancer: implications for disease behavior and prevention. International journal of molecular sciences, 14(8), 16365-16385. Coria-Téllez, A. V., Montalvo-Gónzalez, E., Yahia, E. M., & Obledo-Vázquez, E. N. (2018). Annona muricata: A comprehensive review on its traditional medicinal uses, phytochemicals, pharmacological activities, mechanisms of action and toxicity. Arabian Journal of Chemistry, 11(5), 662-691. Denlinger, C. S., & Barsevick, A. M. (2009). The challenges of colorectal cancer survivorship. Journal of the National Comprehensive Cancer Network, 7(8), 883-894. Dobrzycka, M., Spychalski, P., Łachioski, A. J., Kobiela, P., Jędrusik, P., & Kobiela, J. (2018). Statins and colorectal cancer–a systematic review. Experimental and Clinical Endocrinology & Diabetes. El‐Shami, K., Oeffinger, K. C., Erb, N. L., Willis, A., Bretsch, J. K., Pratt‐Chapman, M. L., ... & Stein, K. D. (2015). American Cancer Society colorectal cancer survivorship care guidelines. CA: a cancer journal for clinicians, 65(6), 427-455. Gauthaman, K., Richards, M., Wong, J., & Bongso, A. (2007). Comparative evaluation of the effects of statins on human stem and cancer cells in vitro. Reproductive biomedicine online, 15(5), 566-581. Gavamukulya, Y., Wamunyokoli, F., & El-Shemy, H. A. (2017). Annona muricata: Is the natural therapy to most disease conditions including cancer growing in our backyard? A systematic review of its research history and future prospects. Asian Pacific journal of tropical medicine, 10(9), 835-848. Hassanabad, A. F. (2019). Current perspectives on statins as potential anti-cancer therapeutics: clinical outcomes and underlying molecular mechanisms. Translational lung cancer research, 8(5), 692.
Higgins, J. P. T., Altman, D. G., & Sterne, J. (2011). Cochrane statistical methods group and the cochrane bias methods group. Chapter 8: Assessing risk of bias in included studies. Cochrane handbook for systematic reviews of interventions Version, 5(0). Indrawati, L., Ascobat, P., Bela, B., Abdullah, M., Surono, I. S., & Pramono, S. (2016). Anti-proliferative activity and caspase enhancement properties of Annona muricata leaves extract against colorectal cancer cells. Medical journal of Indonesia, 25(3), 136-42.
Indrawati, L., Bela, B., Abdullah, M., & Surono, I. S. (2017). The effect of an Annona muricata leaf extract on nutrition status and cytotoxicity in colorectal cancer: a randomized controlled trial. Asia Pacific journal of clinical nutrition.
International Agency for Research on Cancer, I. (2018). Indonesia - Global Cancer Observatory. Retrieved March 23, 2020, from https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pd Ishikawa, S., Hayashi, H., Kinoshita, K., Abe, M., Kuroki, H., Tokunaga, R., ... & Yagi, Y. (2014). Statins inhibit tumor progression via an enhancer of zeste homolog 2‐mediated epigenetic alteration in colorectal cancer. International journal of cancer, 135(11), 2528-2536. Jang, H. J., Hong, E. M., Jang, J., Choi, J. E., Park, S. W., Byun, H. W., ... & Lee, J. (2016a). Synergistic effects of simvastatin and irinotecan against colon cancer cells with or without irinotecan resistance. Gastroenterology research and practice, 2016. Jang, H. J., Hong, E. M., Kim, M., Kim, J. H., Jang, J., Park, S. W., ... & Lee, J. (2016b). Simvastatin induces heme oxygenase-1 via NF-E2-related factor 2 (Nrf2) activation through ERK and PI3K/Akt pathway in colon cancer. Oncotarget, 7(29), 46219. Jang, H. J., Hong, E. M., Park, S. W., Byun, H. W., Koh, D. H., Choi, M. H., ... & Lee, J. (2016c). Statin induces apoptosis of human colon cancer cells and downregulation of insulin-like growth factor 1 receptor via pro-apoptotic ERK activation. Oncology letters, 12(1), 250-256.
Joanna Briggs Institute (2020). JBI Critical appraisal tools. Retrieved July 27, 2020, from https://jbi.global/critical-appraisal-tools Karagkounis, G., DeVecchio, J., Ferrandon, S., & Kalady, M. F. (2018). Simvastatin enhances radiation sensitivity of colorectal cancer cells. Surgical endoscopy, 32(3), 1533-1539. Karjalainen, E., & Repasky, G. A. (2016). Molecular changes during acute myeloid leukemia (AML) evolution and identification of novel treatment strategies through molecular stratification. In Progress in molecular biology and translational science (Vol. 144, pp. 383-436). Academic Press. Kim, Y., Kim, T. W., Han, S. W., Ahn, J. B., Kim, S. T., Lee, J., ... & Kang, W. K. (2019). A Single Arm, Phase II Study of Simvastatin Plus XELOX and Bevacizumab as First-Line Chemotherapy in Metastatic Colorectal Cancer Patients. Cancer research and treatment: official journal of Korean Cancer Association, 51(3), 1128. Kodach, L. L., Bleuming, S. A., Peppelenbosch, M. P., Hommes, D. W., van den Brink, G. R., & Hardwick, J. C. (2007). The effect of statins in colorectal cancer is mediated through the bone morphogenetic protein pathway. Gastroenterology, 133(4), 1272-1281. Kodach, L. L., Jacobs, R. J., Voorneveld, P. W., Wildenberg, M. E., Verspaget, H. W., van Wezel, T., ... & Hardwick, J. C. (2011). Statins augment the chemosensitivity of colorectal cancer cells inducing epigenetic reprogramming and reducing colorectal cancer cell 'stemness' via the bone morphogenetic protein pathway. Gut, 60(11), 1544-1553. Krens, L. L., Simkens, L. H., Baas, J. M., Koomen, E. R., Gelderblom, H., Punt, C. J., & Guchelaar, H. J. (2014). Statin use is not associated with improved progression free survival in cetuximab treated KRAS mutant metastatic colorectal cancer patients: results from the CAIRO2 study. PLoS One, 9(11), e112201.
Kumar, R., & Yarmand-Bagheri, R. (2001). The role of HER2 in angiogenesis. In Seminars in oncology (Vol. 28, pp. 27-32). WB Saunders. Leboeuf, M., Cavé, A., Bhaumik, P. K., Mukherjee, B., & Mukherjee, R. (1980). The phytochemistry of the Annonaceae. Phytochemistry, 21(12), 2783-2813. Lee, J., Jung, K. H., Park, Y. S., Ahn, J. B., Shin, S. J., Im, S. A., ... & Hong, Y. S. (2009). Simvastatin plus irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI) as first-line chemotherapy in metastatic colorectal patients: a multicenter phase II study. Cancer chemotherapy and pharmacology, 64(4), 657-663. Lee, J., Lee, I., Han, B., Park, J. O., Jang, J., Park, C., & Kang, W. K. (2011). Effect of simvastatin on cetuximab resistance in human colorectal cancer with KRAS mutations. JNCI: Journal of the National Cancer Institute, 103(8), 674-688. Lee, J. Y., Kim, M. S., Ju, J. E., Lee, M. S., Chung, N., & Jeong, Y. K. (2018). Simvastatin enhances the radiosensitivity of p53‑deficient cells via inhibition of mouse double minute 2 homolog. International journal of oncology, 52(1), 211-218. Lee, S. J., Lee, I., Lee, J., Park, C., & Kang, W. K. (2014). Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, potentiate the anti-angiogenic effects of bevacizumab by suppressing angiopoietin2, BiP, and Hsp90α in human colorectal cancer. British journal of cancer, 111(3), 497-505. Li, G., Zheng, J., Xu, B., Ling, J., Qiu, W., & Wang, Y. (2017). Simvastatin inhibits tumor angiogenesis in HER2-overexpressing human colorectal cancer. Biomedicine & Pharmacotherapy, 85, 418-424. Lim, S. H., Kim, T. W., Hong, Y. S., Han, S. W., Lee, K. H., Kang, H. J., ... & Lee, J. (2015a). A randomised, double-blind, placebo-controlled multi-centre phase III trial of XELIRI/FOLFIRI plus simvastatin for patients with metastatic colorectal cancer. British journal of cancer, 113(10), 1421-1426. Lim, T., Lee, I., Kim, J., & Kang, W. K. (2015b). Synergistic effect of simvastatin plus radiation in gastric cancer and colorectal cancer: implications of BIRC5 and connective tissue growth factor. International Journal of Radiation Oncology* Biology* Physics, 93(2), 316-325. Liu, B. S., Xia, H. W., Zhou, S., Liu, Q., Tang, Q. L., Bi, N. X., ... & Bi, F. (2018). Inhibition of YAP reverses primary resistance to EGFR inhibitors in colorectal cancer cells. Oncology reports, 40(4), 2171-2182. Lu, L., Huang, W., Hu, W., Jiang, L., Li, Y., Wu, X., ... & Li, M. (2019). Kruppel-like factor 2 mediated anti-proliferative and anti-metastasis effects of simvastatin in p53 mutant colon cancer. Biochemical and biophysical research communications, 511(4), 772-779. Luput, L., Licarete, E., Drotar, D. M., Nagy, A. L., Sesarman, A., Patras, L., ... & Tomuta, I. (2018). In vivo double targeting of C26 colon carcinoma cells and microenvironmental protumor processes using liposomal simvastatin. Journal of Cancer, 9(2), 440. Luput, L., Sesarman, A., Porfire, A., Achim, M., Muntean, D., Casian, T., ... & Tomuta, I. (2020). Liposomal simvastatin sensitizes C26 murine colon carcinoma to the antitumor effects of liposomal 5‐fluorouracil in vivo. Cancer Science, 111(4), 1344. Malicki, S., Winiarski, M., Matlok, M., Kostarczyk, W., Guzdek, A., & Konturek, P. C. (2009). IL-6 and IL-8 responses of colorectal cancer in vivo and in vitro cancer cells subjected to simvastatin. J Physiol Pharmacol, 60(4), 141-146.
Marley, A. R., & Nan, H. (2016). Epidemiology of colorectal cancer. International journal of molecular epidemiology and genetics, 7(3), 105. Menter, D. G., Ramsauer, V. P., Harirforoosh, S., Chakraborty, K., Yang, P., Hsi, L., ... & Krishnan, K. (2011). Differential effects of pravastatin and simvastatin on the growth of tumor cells from different organ sites. PloS one, 6(12), e28813. Moghadamtousi, S. Z., Karimian, H., Rouhollahi, E., Paydar, M., Fadaeinasab, M., & Kadir, H. A. (2014). Annona muricata leaves induce G1 cell cycle arrest and apoptosis through mitochondria-mediated pathway in human HCT-116 and HT-29 colon cancer cells. Journal of ethnopharmacology, 156, 277-289. Moghadamtousi, S. Z., Rouhollahi, E., Karimian, H., Fadaeinasab, M., Firoozinia, M., Abdulla, M. A., & Kadir, H. A. (2015). The chemopotential effect of Annona muricata leaves against azoxymethane-induced colonic aberrant crypt foci in rats and the apoptotic effect of acetogenin annomuricin E in HT-29 cells: a bioassay-guided approach. PLoS One, 10(4), e0122288. Moghadasian, M. H. (1999). Clinical pharmacology of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Life sciences, 65(13), 1329-1337.
Moher, D., & Liberati, A. A., Tetzlaff, J., & Altman, DG (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 339, b2535. Mokhtari, R. B., Homayouni, T. S., Baluch, N., Morgatskaya, E., Kumar, S., Das, B., & Yeger, H. (2017). Combination therapy in combating cancer. Oncotarget, 8(23), 38022. Palko-Łabuz, A., Środa-Pomianek, K., Wesołowska, O., Kostrzewa-Susłow, E., Uryga, A., & Michalak, K. (2019). MDR reversal and pro-apoptotic effects of statins and statins combined with flavonoids in colon cancer cells. Biomedicine & Pharmacotherapy, 109, 1511-1522. Pisanti, S., Picardi, P., Ciaglia, E., D’Alessandro, A., & Bifulco, M. (2014). Novel prospects of statins as therapeutic agents in cancer. Pharmacological research, 88, 84-98.
Pollock, A., & Berge, E. (2018). How to do a systematic review. International Journal of Stroke, 13(2), 138-156. Qi, X. F., Kim, D. H., Yoon, Y. S., Kim, S. K., Cai, D. Q., Teng, Y. C., ... & Lee, K. J. (2010). Involvement of oxidative stress in simvastatin-induced apoptosis of murine CT26 colon carcinoma cells. Toxicology letters, 199(3), 277-287. Rady, I., Bloch, M. B., Chamcheu, R. C. N., Banang Mbeumi, S., Anwar, M. R., Mohamed, H., ... & Whitfield, G. K. (2018). Anti-cancer properties of Graviola (Annona muricata): a comprehensive mechanistic review. Oxidative medicine and cellular longevity, 2018. Rawla, P., Sunkara, T., & Barsouk, A. (2019). Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors. P , 14(2), 89. Riganti, C., Doublier, S., Costamagna, C., Aldieri, E., Pescarmona, G., Ghigo, D., & Bosia, A. (2008). Activation of nuclear factor-κB pathway by simvastatin and RhoA silencing increases doxorubicin cytotoxicity in human colon cancer HT29 cells. Molecular pharmacology, 74(2), 476-484. Shojaei, F. (2012). Anti-angiogenesis therapy in cancer: current challenges and future perspectives. Cancer letters, 320(2), 130-137.
Sideris, M., & Papagrigoriadis, S. (2014). Molecular biomarkers and classification models in the evaluation of the prognosis of colorectal cancer. Anti-cancer research, 34(5), 2061-2068. Środa-pomianek, K., Michalak, K., Palko-łabuz, A., Uryga, A., Szczęśniak-sięga, B., & Wesołowska, O. (2019). Simvastatin Strongly Augments Pro-apoptotic, Anti-inflammatory and cytotoxic activity of oxicam derivatives in doxorubicin-resistant colon cancer cells. Anti-cancer research, 39(2), 727-734.
Sterne, J. A. C., Savovid, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., ... & Stew, H. J. (2019). RoB 2: A revised Cochrane risk-of-bias tool for randomized trials. Bmj, 366, 1-24. Talreja, O., & Cassagnol, M. (2019). Simvastatin. Treasure Island (FL): StatPearls Publishin. Wahab, A., Mariam, S., Jantan, I., Haque, M., & Arshad, L. (2018). Exploring the leaves of Annona muricata L. as a source of potential anti-inflammatory and anti-cancer agents. Frontiers in pharmacology, 9, 661. Wang, F., Liu, W., Ning, J., Wang, J., Lang, Y., Jin, X., ... & Ma, J. (2018). Simvastatin suppresses proliferation and migration in non-small cell lung cancer via pyroptosis. International journal of biological sciences, 14(4), 406. Widjaja, S., & Yo, H. (2016). RM-049Colorectal cancer in Indonesia-a centre report. Annals of Oncology, 27(Suppl 2), ii97. Xiong, S., Grijalva, R., Zhang, L., Nguyen, N. T., Pisters, P. W., Pollock, R. E., & Yu, D. (2001). Up-regulation of vascular endothelial growth factor in breast cancer cells by the heregulin-β1-activated p38 signaling pathway enhances endothelial cell migration. Cancer research, 61(4), 1727-1732. Yang, C., Gundala, S. R., Mukkavilli, R., Vangala, S., Reid, M. D., & Aneja, R. (2015). Synergistic interactions among flavonoids and acetogenins in Graviola (Annona muricata) leaves confer protection against prostate cancer. Carcinogenesis, 36(6), 656-665. Zheng, X. F., Liu, K. X., Wang, X. M., Zhang, R., & Li, X. (2019). MicroRNA‑192 acts as a tumor suppressor in colon cancer and simvastatin activates miR‑192 to inhibit cancer cell growth. Molecular medicine reports, 19(3), 1753-1760
Published
2021-09-30
How to Cite
Amadea, I., & Atrasina, D. (2021). The Effects of Simvastatin and Soursop (Annona muricata) Leaf Extract on Colorectal Cancer. Indonesian Journal of Life Sciences, 3(1), 1-17. https://doi.org/https://doi.org/10.54250/ijls.v3i1.118
Section
Indonesian Journal of Life Sciences