Systematic Review and Meta-analysis Indicating Curcumin to Enhance the Synergistic Potential of Paclitaxel and Reduce Cell Viability, Tumor Volume, and Drug Resistance in Different Cancers

Background: To treat diseases like cancer, conventional Paclitaxel (PTX)- based monotherapy treatment regimens are becoming less effective due to the development of resistance. In this aspect, the phytomolecule curcumin (Cur), having ethnopharmacological importance in traditional South Asian remedies, like Ayurveda and Chinese traditional medicine, has been studied as a promising chemo-sensitizing and synergistic partner of PTX. Aim: This study aimed to evaluate the combined effect of PTX and Cur compared to PTX therapy alone in the in vitro and in vivo environments. Materials and Methods: An extensive PubMed search was performed wherein 169 papers were shortlisted and screened to identify 30 studies that have reported the effect of PTX and Cur either in vitro, in vivo, or both. The pooled Odds Ratio (OR) was calculated at a 95% Confidence Interval (CI) for determining the effect of combination therapy. Results: The meta-analysis has indicated PTX and Cur combination therapy to be associated with a significant decrease in cell viability (OR: 0.37, 95% CI: 0.27-0.51; p < 0.01) and tumor volume (OR: 0.32, 95% CI: 0.15-0.71; p = 0.01). Additionally, the effect of this combination on drug-resistant cell lines has exhibited a significant decrease in the odds of cell viability (OR: 0.45, 95% CI: 0.35-0.57; p < 0.01). Conclusion: Overall, the current meta-analysis has shown PTX and Cur combination to effectively inhibit the viability of cancer cells, reduce tumor volume, and diminish the growth of drug-resistant cancer cells.