Cytotoxic Test Combination of Ethyl Acetate Extract Africant Leaves (Vernonia amygdalina Delile) and Gemcitabine on PANC-1 Cells

African leaves (Vernonia amygdalina Del.) is a plant from the asteraceae family and is popular in Africa society. This plant contains various bioactive compounds that have been identified including flavonoids, saponins, alkaloids, tannins, phenolics, terpenes, steroids, glycosides, triterpenoids and sesquiterpene lactones. This plant is used in traditional medicine as an anticancer agent and can reduce the viability of some cancer cells. This study aimed to determine the cytotoxic effect of ethyl acetate extract african leaves and to determine the activity of the combination of african leaves ethyl acetate extract and gemcitabine in PANC-1 cells. Preparation of extracts was done by maceration using ethyl acetate solvent as well as performed phytochemical screening and characterization of simplicia and extracts. The cytotoxic tests of extract against PANC-1 cells using the MTT assay method. The test results of ethyl acetate extract african leaves cytotoxic againts PANC-1 cells giving IC₅₀ value of 21,83 ± 0,48 μg/mL. Furthermore, the combination of ethyl acetate extract african leaves with gemcitabine in PANC-1 cells gave a strong synergistic effect with a CI (Combination Index) value of 0,18 at a concentration of 3,75 µg/mL ethyl acetate extract african leaves - 17,5 µg/mL Gemcitabine. Gemcitabine is not able to induce apoptosis, but when combined with the extract causes cells to undergo apoptosis. The result of this study could be concluded that ethyl acetate extract african leaves have cytotoxic effects on pancreatic cancer cells and ethyl acetate extract african leaves can be combined with gemcitabine as a anticancer pancteatic because of the synergistic effect.