Punica granatum L. Constituents for Cancer Prevention, Chemosensitisation and Therapeutic Treatment

Cancer is still a major public health burden because its incidence and mortality continue to increase worldwide. The limited treatment options for patients with advanced stages, the severe toxicity, the onset of multiple drug resistance and the high costs of current anticancer therapies favor poor prognosis and high mortality rates. Thus, the identification and development of preventive and cost effective therapeutic strategies to reverse cancer-associated morbidity and mortality are needed. Vegetable and fruit consumption is associated with decreased risk of cancer because of its chemopreventive and chemotherapeutic effects. The use of Punica granatum preparations has a long ethnomedical history and preclinical research has reported many pharmacological activities, including chemopreventive, chemosensitisation and chemotherapeutic effects. Many of these health beneficial effects are related to its complex chemical composition and synergistic interactions of its colonic microbial metabolites including ellagic acid, ellagitannins, punicic acid, flavonoids, anthocyanidins, anthocyanins, and estrogenic flavonols. This chapter summarizes the scientific evidence supporting anticancer effects of pomegranate constituents, focusing on its molecular targets and anticancer mechanisms of action, along with a critical evaluation of pomegranate polyphenols as future anticancer agents.