Anticancer Mechanism of Zerumbone in Cervical Cancer and Precancerous Cervical Lesions: A Protocol for Systematic Review
Tuan Nur Ain Nazurah Tuan Mustapha, Raja Zarith Fatiah Raja Malek Ridhuan, Armania Nurdin, Nik Noorul Shakira Mohamed Shakrin, Nur Aishah Che Roos, Marami Mustapa, Roszaman RamliAbstract
Cervical cancer (CCa) is caused by persistent infection with high-risk human papilloma virus. This burden is mostly diagnosed in low- and middle-income countries, where access to healthcare is limited. The current treatment modalities including surgery, radiotherapy, chemotherapy and immunotherapy are often associated with adverse drug reaction, limited efficiency and high costs. This systematic review aims to evaluate the chemopreventive potential of zerumbone (ZER) in the precancerous CCa lesions and CCa. The protocol is developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis protocols and structured using Population, Intervention, Exposure, Comparison, Outcomes and Study framework. Eligibility criteria will include clinical trial involving women that diagnosed with CCa or/and precancerous lesion, animals’ model of rodents that being implemented with the CCa xenograft and CCa cells lines. Electronic database such as PubMed, Scopus, Science Direct and CENTRAL will be systematically searched for English-language publications. The risk of bias (RoB) in clinical trials will be assessed using the Cochrane RoB 2.0 tools, while animal studies will be evaluated using the Systematic Review Centre for Laboratory Animal Experimentation RoB tool. Meta-analysis will be conducted where feasible. The review will provide a comprehensive synthesis of molecular mechanism and signalling pathways that influence by ZER. The findings are expected to provide a better understanding of ZER’s role in CCa progression.