Written by Karen Pilkington and the CAM-Cancer Consortium.
Updated February 8, 2017

Echinacea spp

Does it work?

Systematic reviews, meta-analyses

Systematic reviews and meta-analyses of the effectiveness of echinacea have been published but these are limited to its use in prevention or treatment of the common cold.6,22,23 No systematic reviews have focused on its use in cancer patients.

Clinical trials

Several clinical trials investigated the effects of a combination product (Esberitox®) containing echinacea in the management of radiation-induced leucopenia. Few details of the early studies are available.2,24,25,26

Subsequent studies also utilised a combination product and the presence of other herbs in the preparations complicates the interpretation of the findings with respect to echinacea.27-29

A more recent open prospective study with matched historical controls tested whether a polysaccharide fraction isolated from Echinacea purpurea reduced unwanted effects of chemotherapy.30 Fifteen patients with advanced gastric cancer received daily intravenous injections of the polysaccharide fraction for 10 days starting 3 days before the start of palliative chemotherapy. After treatment, the median number of leucocytes was significantly greater than that in the control group. No clinically relevant effects on phagocytic activity or lymphocyte subpopulations were observed. Adverse events including two deaths were reported but these were considered likely to be due to chemotherapy or the patients’ overall health condition. It is difficult to draw firm conclusions on beneficial or adverse effects due to the small sample size of the study and lack of a concurrent control group.

Case series/studies

Only a few attempts to investigate echinacea’s role as an anti-cancer agent have been made. Preliminary studies have investigated the anti-cancer effects of Echinacea purpurea extracts combined with chemotherapy in patients with advanced metastatic colorectal cancer who had received surgery and/or chemotherapy were treated with the extract (Echinacin®) plus cyclophosphamide and thymostimulin.31 The treatment appeared well-tolerated but no major beneficial effects resulted and survival times corresponded to those expected for untreated patients.7 Similar studies were conducted in small numbers of patients with advanced pancreatic cancer and hepatocellular cancer.32,33,34 All studies were reported between 1990 and 1994.

Pre-clinical studies

As described under Mechanism of Action, several constituents of echinacea (heteroxylan, arabinogalactan, cichoric acid, echinacosides) have been shown in in-vitro, in-vivo and ex-vivo studies to induce changes in immune parameters. However, there is no evidence that these activities translate to beneficial outcomes in oncology. A diene olefin isolated from Echinacea angustifolia and Echinacea pallida root oils was reported to have antitumour activity in 1972.35 A subsequent in vitro study appeared to indicate that root extracts from the three commonly used species of echinacea reduced cancer cell viability and induced apoptosis.36 A further in vitro study showed Echinacea purpurea flower extract and cichoric acid to have a growth-inhibitory effect against colon cancer cells.47 Research interest has focused on acetylenes present in Echinacea pallida extract and alkamides isolated from Echinacea angustifolia.37,38,39

Citation Karen Pilkington, CAM-Cancer Consortium. Echinacea spp [online document]. http://ws.cam-cancer.org/The-Summaries/Herbal-products/Echinacea-spp. February 8, 2017.

References

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  5. European Medicines Agency. Committee on Herbal Medicinal Products (HMPC): Community herbal monograph on Echinacea purpurea (l.) moench, herba recens. London: European Medicines Agency. 2008.
  6. Linde K, Barrett B, Wölkart K, Bauer R, Melchart D. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530.
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  8. Mills S and Bone K. Echinacea. In: Principles and practice of phytotherapy: modern herbal medicine. London: Churchill Livingstone. 2000.
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  13. Gertsch J., Schoop R., Kuenzle U. and Suter A.: Echinacea alkylamides modulate TNF-α gene expression via cannabinoid receptor CB2 and multiple signal transduction pathways. FEBS Letters 2004 577 (3):563-569.
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  30. Melchart D, Clemm C, Weber B, Draczynski T, Worku F, Linde K, et al. Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy - a pilot study. Phytotherapy Research 2002;16(2):138-42.
  31. Lersch C, Zeuner M, Bauer A, Siemens M, Hart R, Drescher M, et al. Nonspecific immunostimulation with low doses of cyclophosphamide (LDCY), thymostimulin, and Echinacea purpurea extracts (echinacin) in patients with far advanced colorectal cancers: preliminary results. Cancer Investigation 1992;10(5):343-8.
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  47. Tsai YL, Chiu CC, Yi-Fu Chen J, Chan KC, Lin SD. Cytotoxic effects of Echinacea purpurea flower extracts and cichoric acid on human colon cancer cells through induction of apoptosis. J Ethnopharmacol 2012;143(3):914-9.48.
  48. Goey AK, Meijerman I, Rosing H, Burgers JA, Mergui-Roelvink M, Keessen M, Marchetti S, Beijnen JH, Schellens JH. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 2013; 76(3):467-74.