Abstract
As per cancer statistics, breast cancer is the most prevalent cancer in South African women, accounting for 22.6% of all cancers in women and 16% of cancer deaths in women. Phytochemicals/secondary metabolites are compounds found in plants that have antitumor, antiproliferative, and antioxidant effects used in traditional medicine. Current systematic studies on the use of phytochemicals for various diseases have proved to have significant success with reduced side effects. Photodynamic therapy (PDT) is a cancer therapeutic modality, which has been approved for treating various cancer types. Although being promising for cancer treatment, both phytomedicine and PDT suffers from their own limitations. Combination therapy is one of the avenues being explored to overcome those limitations with enhanced therapeutic outcome. This study aims to investigate the combined anticancer effect of IC 50 dose of hypericin mediated PDT with 1 J/cm 2 laser treatment at 594 nm to enhance the anticancer potential of P. granatum ethyl acetate extract against MCF-7 cells. Cytotoxicity in MCF-7 cells treated with extract, PDT alone and in combination was evaluated with 3-(4,5-dimethyl-2-thiazyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Morphological changes were investigated using brightfield microscopy and cell death analysis using Annexin V/PI flow cytometry assay. The results showed enhancement in cytotoxicity (~90%) in combination treatment at a dose of 400 g/mL of P. granatum aril ethyl acetate extract and 0.09 M hypericin-PDT in comparison to single treatment. In conclusion, P. granatum and hypericin-mediated PDT in combination treatment for breast cancer is a viable treatment modality for further investigation.