Artesunate

Simple And Promising Cancer Treatment.

An antimalarial pill costing just $1.50 a pop is being tested as a potential new wonder drug for people with bowel cancer.

This year, an estimated 17,000 people will be diagnosed with bowel cancer in Australia and more than 4,000 will die. About six out of 10 people with the disease survive beyond five years.

But a small trial of the drug artesunate, which is based on an ancient Chinese herbal remedy, looks promising as a cancer treatment.

Many researchers now believe old-fashioned cheap drugs like this will be the next big breakthrough in cancer treatment. A recent study showed that a daily dose of aspirin can double the life expectancy of patients with some cancers.

Dorothy Bradshaw, 65, was part of the clinical trial at St George’s University of London looking at the cancer-fighting potential of artesunate five years ago. She took pills every day for two weeks before surgery to remove her colon containing a 3.5cm tumour but since she had no side effects she assumed she was in the placebo group and forgot all about it.

“I was too busy trying to concentrate on survival,” said Miss Bradshaw, who cheerfully rang round her friends and family to say hello when secretly she was saying goodbye.

The results, however, were striking. After two weeks on the tablets, Miss Bradshaw’s tumour had stopped growing and had not spread. Her colon operation was successful.

Of the 11 patients in the trial who were on the placebo, six had a recurrence of cancer within three-and-a-half years of whom three died. By contrast, of the nine patients who took artesunate, only one had a recurrence and none died.

With such a small study, researchers did not find significant evidence that the antimalarial could actually kill cancer cells but in the artesunate group, levels of the protein Ki67, an indicator of how fast cancer cells are multiplying, dropped by a third. Miss Bradshaw’s Ki67 levels stabilised, indicating her cancer was no longer growing or spreading and was contained in her colon where it could be surgically removed.

St George’s Hospital oncologist Professor Devinder Kumar said: “I’m extremely excited about this. We already know this is a safe drug that has been taken by tens of millions of people around the world to treat malaria.

“If we can repeat the results of this small study in a larger trial this could really be a ground-breaker in the treatment of bowel cancer.”

The researchers at St George’s are now close to embarking on a larger, $500,000 trial involving 140 patients, to see if there is more solid evidence that artesunate could be used to fight cancer.

Though they need a fraction of the millions of pounds spent on many cancer drug trials, the funding is still a stumbling block.

“This drug is no longer protected by patent so it can be made and sold very cheaply. It’s simply not in the pharmaceutical industry’s interests to look at a cancer treatment that would cost a dollar a day,” says Professor Sanjeev Krishna, a molecular parasitologist who has studied antimalarials for 35 years and is leading the study.

“We could apply for funding from a charity or the Medical Research Council but it’s an extremely time-consuming process which can take years. We want to get moving on something that could save lives.”

The researchers’ solution is to go directly to the public and ask for help. They have launched a crowd-funding bid for $110,000 to help cover the trial costs. The rest of the money has already been raised by a tiny charity called Bowel Disease UK which was founded by one of Prof Kumar’s patients as a way of directly funding research at St George’s.

With costly new cancer drugs typically taking at least a decade to come to market, Prof Krishna believes crowd-funded studies on cheap existing drugs could become the norm, getting results more quickly without compromising standards.

He said: “My view is that the future of much of clinical science funding may become patient-led and this could free us from the pursuit of expensive medicines by ’big pharma’.”

Artesunate is just one of many well-established generic drugs that could be given a new use in oncology. Aspirin is the most high-profile example; a recent Dutch study of 14,000 people with cancers of the gastrointestinal tract found those who regularly took aspirin were twice as likely to be still alive after four years.

Dr Pan Pantziarka, the Anticancer Fund’s UK spokesman, said the beauty of these older generic drugs is that they are long-established and known to have few side effects. They came to market at a time when scientists didn’t fully understand how they worked but as a happy accident they can attack cancer on several fronts at once, effectively carpet-bombing the disease and giving it no time to adapt its way out of the onslaught, he said.

By contrast, pharmaceutical companies today invest billions in drugs that act more like snipers.

“It would be extremely expensive and complicated to develop multi-targeted drugs today, so most modern cancer therapies tend to be aimed at one specific target inside cancer cells,”said Dr Pantziarka. “Very often they have a powerful initial impact but then cancer resistance kicks in and the effect wears off.”

He said it would not surprise him if a simple, two-week course of antimalarial pills proved to be a powerful weapon against cancer.

“What kills cancer patients are metastases – the spread of the disease to other parts of the body,” he said. “Tackle that and the chances of survival are much greater.

“Artesunate appears to stop this process from happening if taken before surgery. It’s a very simple intervention but ultimately it means that many lives could be saved.”


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