Abstract
Dear editor,
We read with great interest the recent article “Efficacy of Saffron (Crocus sativus L.) and Its Constituents on Breast Cancer, a Systematic Review of Preclinical Studies and Potential Therapeutic Mechanisms” by Hasheminasab and Azimi. 1 The study provided a comprehensive overview of preclinical studies which highlight the anticancer potential of saffron and its bioactive elements, particularly crocin and crocetin, through mechanisms such as apoptosis induction and cell cycle modulation. We found that even though the systematic review contains important insights, it is notable that clinical evidence on human was missing. Human studies could be considered as a crucial part for translating preclinical studies into therapeutic and active application to patients and following impacts. 1
In this context, we would like to address two randomized, double-blind, placebo-controlled clinical trials that we have conducted. The first study was done in a population of patients with newly diagnosed esophageal squamous cell carcinoma. It demonstrated that crocin administration during chemoradiotherapy improved treatment tolerance, reduced toxicity, and positively influenced anxiety and depression. Moreover, our other study in patients with non-metastatic breast cancer receiving doxorubicin-based chemotherapy showed that crocin supplementation significantly ameliorated anxiety and depression and improved certain chemotherapy-related toxicities, containing a trend toward better survival outcomes.2,3
These findings provide initial but relevant clinical evidence supporting the role of saffron-derived compounds, particularly crocin, not only in targeting cancer cells but also in improving patient quality of life undergoing treatment. Preclinical studies have demonstrated that crocin exerts anticancer effects through several pathophysiological mechanisms, including induction of apoptosis, cell cycle arrest, inhibition of angiogenesis, and modulation of signaling pathways. These mechanisms not only suppress tumor growth but may also enhance sensitivity to conventional chemotherapies. Integrating these clinical findings with preclinical data may lay the foundation for future trials investigating crocin’s therapeutic potential in breast cancer and other malignancies. We appreciate the authors’ valuable contribution and hope that emphasizing clinical evidence will further advance discussions on the translational relevance of saffron in oncology.
