Prostate cancer chemoprevention by silibinin: Bench to bedside

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Abstract
Prostate cancer (PCA) is the most invasive malignancy and second leading cause of cancer deaths in American males. One approach to reduce PCA incidence, growth and metastasis is prevention and intervention targeted towards mitogenic and survival signaling and cell‐cycle regulation. This approach is based on the rationale that overexpression of receptor tyrosine kinases (RTKs) and/or non‐receptor tyrosine kinases leads to persistent autocrine stimulation of malignant cells for deregulated cell‐cycle progression and uncontrolled growth. PCA progression has also been associated with transition from a paracrine to an autocrine relationship between receptors and growth ligands as this malignancy progresses to an advanced androgen‐independent aggressive stage. Together, these studies suggest that targeting RTK‐mediated signaling pathways along with cell‐cycle regulators could be a practical and translational approach for PCA prevention and intervention. Here, we provide evidence that a naturally occurring nontoxic flavanoid, silibinin, targets the epidermal growth factor receptor (EGFR), insulin‐like growth factor‐1 receptor (IGF‐1R) and NF‐κB (nuclear factor‐kappa B) pathways in PCA. Furthermore, it modulates cell‐cycle regulators, including cyclin‐dependent kinases (CDKs), Cip/Kip and cyclins for its anticancer efficacy against PCA. Silibinin inhibits growth of PCA cells from human, mouse, and rat origins, and also suppresses human prostate tumor xenograft growth in nude mice. Silibinin also inhibits PCA growth in the transgenic adenocarcinoma of mouse prostate (TRAMP) mouse model. Now, silibinin has been entered into phase I/II clinical trials in human PCA patients where preliminary observations were suggestive of its further study in a larger base of the patient population.