Page 402 Alternative Medicine Review ◆ Volume 9, Number 4 ◆ 2004 Lung Cancer Review Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission Robert Ancuceanu, MSc Pharm – Lecturer at the Department of the Pharmaceutical Botany; Director General of the Pharmaceutical Directorate of the Romanian Ministry of Health. E-mail: Ancuceanu77@xnet.ro Viorica Istador, PhD – Professor at the Pharmacognosy. Phytochemistry. Phytotherapy Department of the Faculty of Pharmacy, University of Medicine and Pharmacy, Bucharest, Romania Abstract This article consists of an analysis of the available scientific research on botanically derived compounds that have potential efficacy in the treatment of lung cancer. The mechanisms of activity reviewed include alkylating agents, topoisomerase poisons, DNA synthesis inhibitors, protein synthesis inhibitors, immunoceuticals, and lipoxygenase inhibitors. Selection criteria include: (1) products whose activity have at least minimal scientific confirmation – preclinical (in vitro, in vivo) or clinical; (2) products with a well-defined chemical composition; or (3) products with a well-known or scientifically plausible mechanism of activity. (Altern Med Rev 2004;9(4):402-419) Introduction A Medline search was performed to iden- tify herbal compounds (well-defined chemical entities or plants extracts) with activity against lung cancer. Appropriate keywords and Boolean operators were utilized, such as “lung AND can- cer AND plants” and “herbal AND lung AND can- cer.” In most cases, the full-text article was con- sulted; for a smaller number of cases, abstracts were used (articles less recent than 1990 or in Asian languages); and, in a few instances, second- ary references were identified in other accessible articles. Compounds for which there is no known mechanism of activity were not reviewed. In some compounds, apoptotic mechanisms were identi- fied. However, since apoptosis is only a conse- quence of a primary mechanism – such as DNA Pharmacologically Active Natural Compounds for Lung Cancer Robert Viorel Ancuceanu, MSc Pharm, PhD Candidate, and Viorica Istudor, PhD alkylation, poisoning of DNA topoisomerases, or interference with tubuline metabolism – only those with identified primary mechanisms were consid- ered for this review. An Overview of Lung Cancer Lung cancer is currently the most com- mon cancer worldwide, comprising 17 percent of cancers in men (twice the worldwide rate of the second-most common cancer in men – prostate cancer) and 19 percent of cancers in men in de- veloped countries. In women, lung cancer is the third-most common cancer worldwide, after breast and colorectal cancers (accounting for seven per- cent of all cancers in women). 1 Since 1950 in the United States, lung cancer has been the most com- mon cause of cancer deaths in men, and in the 1980s it surpassed breast cancer as the most com- mon cause of cancer death in women. As of 2004, lung cancer continues to account for the highest number of cancer deaths in the United States (32% men; 25% women), although current estimates show new lung cancer cases comprise only 13 and 12 percent of all cancers in the United States, in males and females, respectively. 2 Despite some progress in recent decades, lung cancer remains the leading cause of death from cancer in most