Combination therapy of annona muricata ethanolic extract with cisplatin against MDA-MB-231: triple negative breast cancer cell line

Administration of cytotoxic drug for cancer therapy is associated with resistance, in addition of having narrow therapeutic window. A synergetic combination therapy may allow cytotoxic agents to be administered at lower concentration hence inhibit development of resistance. Existing knowledge of traditional medicinal plants with anticancer properties may be the key to synergism in combination therapy for cancer treatment. Annona muricata is known for its anticancer activities. It may interact with conventional cytotoxic drug and results in synergism interaction. Annona muricata is getting great attention from the public and is being consumed with the belief of its curing effects. It is a well-known, and often used medicinal plant that has been rigorously studied and proven to contain compounds with antiproliferative effect. The aim of this study is to determine the inhibitory concentration of Annona muricata ethanolic extract towards 50% MDA-MB-231 cell population. In addition, this study also assessed possible interaction between the extract and cisplatin in combination treatment. Cell viability following treatment is determined by using MTT assay. An isobologram plot was prepared, in addition to calculations of the Combination Index (CI) and the Fractional Inhibitory Concentration (FIC) index, to assess interaction between the extract and cisplatin. From the study, it is determined that in combination, the two agents were antagonistic.