RESUMEN
Neuroblastoma, a cancer of the sympathetic nervous system, primarily affects infants and children ≤10 yr of age. High-risk neuroblastoma is associated with low survival rates and increased risks of treatment-related side-effects. Therefore, effective treatments that increase survival and reduce adverse side-effects are crucial. Cucurbitacin E (CucE), a nutritional supplement shown to have potential as an alternative to chemotherapy, was investigated for potential impact on neuroblastoma alone and in combination with the standard chemotherapeutic agent, paclitaxel, (PAC). CucE and PAC each inhibited proliferation of murine neuroblastoma cells in culture. Combined treatment with CucE and PAC also induced morphological differentiation. However, both differentiation and antiproliferative effects were reversible. Consequently, while nutritional supplementation represents a potential therapeutic approach toward treatment of cancer, certain nutritional/chemotherapeutic combinations may induce transient rather than permanent effects. Transient inhibition of proliferation by nutritional supplementation could inadvertently protect carcinogenic cells from toxicity otherwise induced by a chemotherapeutic agent. Combinatorial treatments involving nutritional supplements should therefore be utilized with caution.