Activity of Artemisia annua and artemisinin derivatives, in prostate carcinoma.

Abstract

BACKGROUND:

Artemisia annua L, artemisinin and artesunate reveal profound activity not only against malaria, but also against cancer in vivo and clinical trials. Longitudinal observations on the efficacy of A. annua in patients are, however missing as of yet.

METHODS:

Clinical diagnosis was performed by imaging techniques (MRT, scintigraphy, SPECT/CT) and blood examinations of standard parameters from clinical chemistry. Immunohistochemistry of formalin-fixed, paraffin-embedded tumor material was performed to determine the expression of several biomarkers (cycloxygenase-2 (COX2), epidermal growth factor receptor (EGFR), glutathione S-transferase P1 (GSTP1), Ki-67, MYC, oxidized low density lipoprotein (lectin-like) receptor 1 (LOX1), p53, P-glycoprotein, transferrin receptor (TFR, CD71), vascular endothelial growth factor (VEGF), von Willebrand factor (CD31)). The immunohistochemical expression has been compared with the microarray-based mRNA expression of these markers in two prostate carcinoma cell lines (PC-3, DU-145).

RESULTS:

A patient with prostate carcinoma (pT3bN1M1, Gleason score 8 (4+4)) presented with a prostate specific antigen (PSA) level >800 µg/l. After short-term treatment with bacalitumide (50 mg/d for 14 days) and long-term oral treatment with A. annua capsules (continuously 5 × 50 mg/d), the PSA level dropped down to 0.98 µg/l. MRT, scintigraphy and SPECT/CT verified tumor remission. Seven months later, PSA and ostase levels increased, indicating tumor recurrence and skeletal metastases. Substituting A. annua capsules by artesunate injections (2 × 150 mg twice weekly i.v.) did not prohibit tumor recurrence. PSA and ostase levels rose to 1245 µg/l and 434 U/l, respectively, and MRT revealed progressive skeletal metastases, indicating that the tumor acquired resistance. The high expression of MYC, TFR, and VEGFC in the patient biopsy corresponded with high expression of these markers in the artemisinin-sensitive PC-3 cells compared to artemisinin-resistant DU-145 cells.

CONCLUSION:

Long-term treatment with A. annua capsules combined with short-term bicalitumide treatment resulted in considerable regression of advanced metastasized prostate carcinoma. Controlled clinical trials are required to evaluate the clinical benefit of A. annua in prostate cancer.

• Authors: Friedrich-Wilhelm Michaelsen, Mohamed E M Saeed, Jörg Schwarzkopf, Thomas Efferth
• Journal: Phytomedicine : international journal of phytotherapy and phytopharmacology (Phytomedicine) Vol. 22 Issue 14 Pg. 1223-31 (Dec 15 2015) ISSN: 1618-095X [Electronic] Germany
• PMID: 26655404 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier GmbH. All rights reserved.

Chemical References

• Artemisinins
• Biomarkers, Tumor
• Artesunate
• artemisinin
• Prostate-Specific Antigen

Topics

• Aged, 80 and over
• Artemisia annua (chemistry)
• Artemisinins (pharmacology)
• Artesunate
• Biomarkers, Tumor (metabolism)
• Bone Neoplasms (secondary)
• Cell Line, Tumor
• Drug Resistance, Neoplasm
• Humans
• Immunohistochemistry
• Male
• Neoplasm Metastasis
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (drug therapy, pathology)