Synergistic Anticancer Effects of Fermented Noni Extract Combined with 5-Fluorouracil, Doxorubicin, and Vincristine on A549, MCF-7, and SH-SY5Y Cell Models

초록

Although chemotherapy is a primary approach for cancer treatment, its efficacy is often compromised by the development of drug resistance and occurrence of serious side effects. To improve chemotherapy outcomes, this study aimed to evaluate the synergistic anticancer effects of fermented noni extract (FN) in combination with 5-fluorouracil (5-FU), doxorubicin (DOX), or vincristine (VIN) in A549, MCF-7, and SH-SY5Y cancer cell lines. Cells were treated with FN, anticancer drugs, or their combinations. Cell viability was assessed using XTT assays, and synergism was evaluated by calculating combination index (CI) values. Scratch wound and colony formation assays were conducted to assess cell migration and proliferation. Western blotting was used to analyze the expression of apoptosis-related proteins. Combination treatments significantly enhanced cytotoxicity (CI < 1), inhibited migration and colony formation, and induced intrinsic apoptosis. Expression ratios of BAX/BCL-2, cleaved caspase-9/caspase-9, and cleaved caspase-3/caspase-3 notably increased. These findings suggest that FN enhances the efficacy of chemotherapy drugs by promoting intrinsic apoptotic pathways and may serve as a potential natural adjuvant in cancer therapy.

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