silibinin (milk thistle extract) for NSCLC liver mets while on enoxaparin?

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This topic contains 3 replies, has 3 voices, and was last updated by  greaterthan 1 year, 8 months ago.

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March 17, 2016 at 3:57 pm  #1273300    

greaterthan

I searched around and couldn’t find anything specific, so I thought I’d ask a new question. If it turns out that it already has been discussed, please point me in the right direction!

My wife was diagnosed with NSCLC in Sept. of 2015. The main tumor is in her upper-right lobe and there are mets in her spine, pelvis and liver. She had 6 rounds of carboplatin+Alimta, which shrunk the main tumor, but after 3 maintenance infusions of just Alimta, the cancer seems to be getting the upper hand. Her PET/CT-scan 2 days ago shows spread to shoulder, more vertebrae, other side of pelvis and, most alarmingly, to more of her liver. The next line of treatment is likely to be Tarceva, which she tolerated well in the hospital.

In trying to find other ways to help support her system, I was reading about silibinin, which is the active ingredient extracted from milk thistle. From reading about silibinin, it seems to have had good results in helping with NSCLC. Here are a couple of studies:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924887/

http://www.ncbi.nlm.nih.gov/pubmed/23682778

She won’t be starting Tarceva for another 5 days or so, and we’re wondering about trying to support her liver (and perhaps sneak in some of the anti-cancer effects that silibinin might be able to impart) ASAP. The only medication she’s taking right now is enoxaparin (Lovenox), 2x/day.

Now, I’ve read that <span style=”text-decoration:underline;”>milk thistle</span> ( which is a more complex molecule than just pure silibinin) may interact with some thinners, but never anything explicit about silibinin and enoxaparin. All of the negative interactions I could find were about milk thistle extract,. Can anyone speak to this specific combination? How ’bout silibinin’s interaction with Tarceva? Any info would be greatly appreciated!


Wife, 50, never-smoker.
Dx 8/2015 w/ stage-IV NSCLC / adenocarcenoma; main 6cm mass upper-right lobe; mets to lymph nodes, liver, bones. EGFR+ (but rare submutation).
6 rounds Carbo+Alimta 9-12/2015, 3 maint. Alimta 1-2/2016; progr. 2/2016. Tarceva 150mg daily 3/2016. Rad. 10x ea. hip 4/2016. Stable?

March 18, 2016 at 4:49 am  #1273306    
JimC Forum Moderator
JimC Forum Moderator

Hi greaterthan,

I’m sorry to hear of your wife’s progression, and I hope that Tarceva is effective and tolerable for her.

The use of supplements, especially during anti-cancer treatment, is a difficult one. There is a multitude of supplements available, almost none of which have been tested in clinical trials to determine the possibility of a negative interaction.

With regard to silibinin, over the years many medications, supplements and other interventions have shown promise in the lab and in mice, only to prove ineffective (or at times even harmful) in human clinical trials. I’m not saying that is the case with silibinin, but that at this point the odds are stacked against it, as with any new idea. With that in mind, and the lack of evidence of possible interactions anti-cancer drugs in human trials, caution may be advised.

Although I see your point about the difference between milk thistle extract and silibinin, if you have seen information about an interaction with enoxaparin, I would be concerned that it is the active ingredient in milk thistle extract that is causing the interaction, and that taking what may be a higher concentration of silibinin than what is found in the extract may not be advisable.

Good luck with Tarceva.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

March 18, 2016 at 1:58 pm  #1273314    

cards7up

When it comes to herbal supplements, I like to check Memorial Sloan Kettering herb site. Here is a link that you can read up on milk thistle. This would not be all inclusive since there are newer drugs out there like Tarceva. You should not take higher doses of milk thistle as it can actually raise the liver levels.
Take care, Judy
https://www.mskcc.org/cancer-care/integrative-medicine/herbs/milk-thistle


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

March 23, 2016 at 12:57 pm  #1273364    

greaterthan

Thank you, Jim and cards7up, for the information and advice.


Wife, 50, never-smoker.
Dx 8/2015 w/ stage-IV NSCLC / adenocarcenoma; main 6cm mass upper-right lobe; mets to lymph nodes, liver, bones. EGFR+ (but rare submutation).
6 rounds Carbo+Alimta 9-12/2015, 3 maint. Alimta 1-2/2016; progr. 2/2016. Tarceva 150mg daily 3/2016. Rad. 10x ea. hip 4/2016. Stable?

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