Curcumin gum formulation for prevention of oral cavity head and neck squamous cell carcinoma
Lindsay Boven MD  Sean P. Holmes MD  Brian Latimer MS  Kenneth McMartin PhD  Xiaohui Ma MD Tara Moore‐Medlin BS  Alok R. Khandelwal PhD  Jerry McLarty PhD  Cherie‐Ann O. Nathan MD, FACS
First published: 13 November 2018 https://doi.org/10.1002/lary.27542
This project was selected as the winner of the Southern Section Lester A. Brown, MD Resident Research Award at the Triological Society Combined Sections Meeting, Scottsdale, Arizona, U.S.A., January 18–20, 2018.
This work was funded by a Louisiana State University Leveraging Innovation for Technology Transfer (LIFT) grant 2014: A Novel Curcumin Chewing Gum in the Prevention of Upper Aerodigestive Tract Malignancies.
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
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Abstract
Objectives/Hypothesis
Head and neck squamous cell carcinoma represents the sixth most common cancer. As a result of field cancerization, second primaries and recurrences are high. Hence, research has focused on chemoprevention. Curcumin, a polyphenol compound with anticarcinogenic properties, is one such promising nutraceutical. As poor bioavailability limits curcumin's use, a novel gum formulation was tested allowing for direct mucosal absorption into the bloodstream. This preliminary study validates curcumin gum efficacy by assessing release and transmucosal absorption, along with measuring its effects on serum cytokine levels.

Study Design
Clinical trial.

Methods
Protocols consisting of initial chew (chewing gum for 30 minutes) and revised chew (alternating chewing and parking gum against buccal mucosa for 30 minutes) were tested in healthy volunteers. High‐performance liquid chromatography measured remnant curcumin in chewed gum, serum, and saliva. Serum levels were assayed for 15 proinflammatory cytokines via multiplex analysis.

Results
Revised chew samples demonstrated significantly higher curcumin release and absorption (P = .0078). Curcumin serum levels were significantly higher at 4 hours in samples > 2.0 g of curcumin release (P = .01). As saliva levels decreased, a concurrent increase in serum levels was observed, with no significance in the inverse relationship (P = .1423). When evaluating differences between gender, race, and age, the Asian population showed significantly lower curcumin release and serum levels (P = .009). CXCL1 (GRO‐α) and TNF‐α were significantly decreased in serum after chewing the gum (P = .036, P < .001, respectively).

Conclusions
Enhanced mucosal contact appears critical in improving curcumin release and absorption. CXCL1 and TNF‐α both represent potential biomarkers for the future study of curcumin chemoprevention.

Level of Evidence
2b

Laryngoscope, 129:1597–1603, 2019