Anticancer Treatment-induced Cognitive Toxicities
Few studies evaluated the protective effect of Ginkgo against cognitive toxicities associated with anticancer treatment, and only 1 study was placebo-controlled.
Researchers conducted an open-label phase 2 study of 34 patients with a brain tumor who received partial or whole brain radiation at least 6 months prior to enrollment and no evidence of disease progression during the last 3 months.14 All patients received 120 mg daily of Ginkgo for 24 weeks, then a treatment-free washout period for 6 weeks. Significant improvements were observed for executive function, attention/concentration, nonverbal memory, mood, Functional Assessment of Cancer Therapy brain and physical subscale.
A double-blind, phase 3 trial randomly assigned 166 women with newly diagnosed breast cancer to receive 60 mg of Ginkgo extract or placebo twice daily, in addition to adjuvant chemotherapy.15 The study treatment was initiated before their second cycle of chemotherapy and continued until 1 month after chemotherapy completion. There was no significant improvement in cognitive function or mood, though there was a modest improvement in nausea (P = .05) among patients who received Ginkgo compared with placebo.
The available human studies do not support the role of Ginkgo biloba as a treatment for cancer, but the published studies were not placebo-controlled, making it difficult to draw conclusions from the data.
Other studies found no evidence of a protective effect of Ginkgo supplementation against cognitive toxicities associated with radiation or chemotherapy. It is, however, well-tolerated and does not appear to increase the risk of toxicities or affect the efficacy of anticancer therapies. Ginkgo is also not associated with an increased or decreased risk of cancer.
- Ginkgo. National Institutes of Health website. https://nccih.nih.gov/health/ginkgo/ataglance.htm. Updated March 2017. Accessed October 9, 2017.
- Biggs ML, Sorkin BC, Nahin RL, Kuller LH, Fitzpatrick AL. Ginkgo biloba and risk of cancer: secondary analysis of the Ginkgo Evaluation of Memory (GEM) Study. Pharmacoepidemiol Drug Saf. 2010;19:694-8. doi: 10.1002/pds.1979
- Brasky TM, Kristal AR, Navarro SL, et al. Specialty supplements and prostate cancer risk in the VITamins and Lifestyle (VITAL) cohort. Nutr Cancer. 2011;63:573-82. doi: 10.1080/01635581.2011.553022
- Hotaling JM, Wright JL, Pocobelli G, Bhatti P, Porter MP, White E. Long-term use of supplemental vitamins and minerals does not reduce the risk of urothelial cell carcinoma of the bladder in the VITamins And Lifestyle study. J Urol. 2011;185;1210-5. doi: 10.1016/j.juro.2010.11.081
- Jiang W, Cong Q Wang Y, Ye B, Xu C. Ginkgo may sensitize ovarian cancer cells to cisplatin: antiproliferative and apoptosis-inducing effects of Ginkgolide B on ovarian cancer cells. Integrative Cancer Ther. 2014;13:NP10-7. doi: 10.1177/1534735411433833
- Liu SQ, Xu CY, Quin MB, et al. Ginkgo biloba extract enhances chemotherapy sensitivity and reverses chemoresistance through suppression of the KSR1mediated ERK1/2 pathway in gastric cancer cells. Oncol Rep. 2015;33:2871-82. doi: 10.3892/or.2015.3923
- Ma J, Duan W, Han S, et al. Ginkgolic acid suppresses the development of pancreatic cancer by inhibiting pathways driving lipogenesis. Oncotarget. 2015;6:20993-1003.
- Park YJ, Kim MJ, Kim HR, Yi MS, Chung KH, Oh SM. Chemopreventive effects of Ginkgo biloba extract in estrogen-negative human breast cancer cells. Arch Pharm Res. 2013;36:102-8. doi: 10.1007/s12272-013-0002-0
- Park YJ, Ahn HY, Kim HR, Chung KH, Oh SM. Ginkgo biloba extract EGb 761-mediated inhibition of aromatase for the treatment of hormone-dependent breast cancer. Food Chem Toxicol. 2016;87:157-65.
- Dias MC, Furtado KS, Rodrigues MA, Barbisan LF. Effects of Ginkgo biloba on chemically-induced mammary tumors in rats receiving tamoxifen. BMC Comp Alt Med. 2013;13:93.
- Hauns B, Häring B, Köhler S, Mross K, Robben-Bathe P, Unger C. Phase II study with 5-fluorouracil and ginkgo biloba extract (GBE 761 ONC) in patients with pancreatic cancer. Arzneimittelforschung. 1999;49:1030-4.
- Hauns B, Häring B, Köhler S, Mross K, Unger C. Phase II study of combined 5-fluorouracil/ Ginkgo biloba extract (GBE 761 ONC) therapy in 5-fluorouracil pretreated patients with advanced colorectal cancer. Phytother Res. 2001;15:34-8.
- Cai Z, Wang C, Liu P, Shen P, Han Y, Liu N. Ginkgo biloba extract in combination with sorafenib is clinically safe and tolerable in advanced hepatocellular carcinoma patients. Phytomedicine. 2016;23:1295-300. doi: 10.1016/j.phymed.2016.07.002
- Attia A, Rapp SR, Case LD, et al. Phase II study of Ginkgo biloba in irradiated brain tumor patients: effect on cognitive function, quality of life, and mood. J Neurooncol. 2012;109:357-63. doi: 10.1007/s11060-012-0901-9
- Barton DL, Burger K, Novotny PJ, et al. The use of Ginkgo biloba for the prevention of chemotherapy-related cognitive dysfunction in women receiving adjuvant treatment for breast cancer, N00C9. Support Care Cancer. 2013;21:1185-92. doi:10.1007/s00520-012-1647-9