Artemisinin - What's The Straight Dope?

[Agnostic_Pagan]

99% of the med articles I see on Facebook are obviously bogus. They lead to miscellaneous blogs written by anonymous editors that cite spurious research if any. I’ve seen a few that were straight out plagiarism of older news stories presented as cutting edge research.

So as I googled the latest effort I found this one actually had some validity. I don’t care to link to the original article since they make it appear all you have to do is brew some tea with this stuff or something similar, and Woo! no more cancer!

I doubt its that simple, but perusing PubMed found the following, among several others,

Effect of artemisinin derivatives on apoptosis and cell cycle in prostate cancer cells.

Effect of Artemisinin Derivatives on Apoptosis and Cell Cycle in Prostate...

Development of artemisinin compounds for cancer treatment.

Development of Artemisinin Compounds for Cancer Treatment - PubMed

However, simple artemisinin analogs are less potent than traditional cancer chemotherapeutic agents and have short plasma half-lives, and would require high dosage and frequent administration to be effective for cancer treatment. More potent and target-selective artemisinin-compounds are being developed. These include artemisinin dimers and trimers, artemisinin hybrid compounds, and tagging of artemisinin compounds to molecules that are involved in the intracellular iron-delivery mechanism. These compounds are promising potent anticancer compounds that produce significantly less side effect than traditional chemotherapeutic agents.

I grasp that when artemisinin is combined with iron, it has shown effectiveness at killing cancer cells. But the details are above my pay grade.

The original research appears to date from 2004, so one of my questions is what is taking so long? I have no reference frame for how long it should take, but I would think something this effective at treating cancer would be more widespread by now with pharma companies competing to see who could get a drug to market first. And that I would have heard about this from a more mainstream source.

So I imagine there are some roadblocks that have been hit along the way, as referenced in the abstract above, but, again, have no frame of reference as to how high or severe those roadblocks are.

Anyone with more familiarity care to fight some ignorance? Thanks in advance.

[running_coach]

There is no one-shot, single cure for cancer. Period. Doubly so if it involves brewing tea.

Just because something works in a petri dish doesn’t mean it works in the infinitely more complex human body.

The reason that there’s no further story since 2004 is it didn’t pan out.

[Agnostic_Pagan]

The articles I linked to were from 2010 and 2013. A viable cost-effective treatment has not been produced. I am interested in is if someone knowledgeable about pharmaceutical development knows if this process is taking longer than usual or not, and what might cause the process to take longer than normal if that is the case.

I do not believe that there will be a single cure-all for all types of cancer - it is too broad a category with too many factors involved, but this has shown effectiveness in treating lung cancer and prostate cancer from the articles I skimmed over. Just not as cost-effective currently as existing standard treatments.

[even_sven]

I don’t know about cancer, but right now it is the most effective drug for fighting malaria. It’s almost a silver bullet, and saves millions of lives a year.

The story behind it’s modern discover is pretty amazing. In the 1960s, Chairman Mao instituted a project to go through thousands of traditional Chinese herbal medicines reputed to cure malaria and test them. Artemisinin, a type of leaf, was found to be very effective against malaria. It remained a secret, under Chinese control, until 1970. In the 80s, scientists were skeptical, and dismissed it out of hand. In the 90s, Novartis finally bought the Chinese patent, and found that it turns out that it actually is an amazingly effective drug. Now, an artemisinin-based combination treatment is the first-line treatment against malaria. I’ve taken it myself, and it probably saved my own life,.

[Smeghead]

Obligatory

There’s a vast universe of difference between “works on cultured cells” and “cures cancer”, sadly.

[dofe]

As the OP already acknowledged, the problems are that:

**However, simple artemisinin analogs are less potent than traditional cancer chemotherapeutic agents and have short plasma half-lives, and would require high dosage and frequent administration to be effective for cancer treatment. **More potent and target-selective artemisinin-compounds are being developed. These include artemisinin dimers and trimers, artemisinin hybrid compounds, and tagging of artemisinin compounds to molecules that are involved in the intracellular iron-delivery mechanism. These compounds are promising potent anticancer compounds that produce significantly less side effect than traditional chemotherapeutic agents.

(emphasis added). My guess is that they have simply not been able to overcome these problems.

When I used to work in pharma research, we had a class of compounds that appeared very promising during in vitro studies. We spent years going back and forth trying to find a compound that was in the sweet spot between efficacy and acceptable side effects. We simply were unable to overcome the side effects we saw during in vivo studies without losing the efficacy of the compound, however.

As others have already noted, there’s a big gulf between a compound that works in the lab versus a drug that is useful in a clinical setting.

[Derleth]

And now it’s becoming less effective as an antimalarial because of growing resistance:

Parasite resistance to artemisinin has so far been detected in four South-East Asian countries: in Cambodia, Myanmar, Thailand, and Viet Nam (all in the Greater Mekong subregion). Resistance has occurred as a consequence of several factors, including poor treatment practices, inadequate patient adherence to prescribed antimalarial regimens, and the widespread availability of oral artemisinin-based monotherapies and substandard forms of the drug.

Given the ever-increasing levels of population movement in Asia and the Pacific, the geographic scope of the problem could widen quickly, posing a health security risk for many countries in the region with ongoing malaria transmission. If resistance were to spread to – or emerge in – India or sub-Saharan Africa, the public health consequences could be dire, as no alternative antimalarial medicine is available at present with the same level of efficacy and tolerability as ACTs. There is therefore a limited window of opportunity to avert a regional public health disaster, which could have severe global consequences.

That’s why the WHO doesn’t want people to use the drug as their only therapy anymore. Always mix it with a different antimalarial.

[Jackmannii]

@Agnostic_Pagan

I would think something this effective at treating cancer would be more widespread by now with pharma companies competing to see who could get a drug to market first.

Of course, Big Pharma has blocked it from getting to market so they can sell a slew of hugely expensive drugs that don’t work.

Or for a sane explanation - a sufficiently effective artemisinin-based cancer drug has not yet been developed, and researchers are simultaneously working on a kazillion other compounds and approaches. So it may well take a while longer before we see something on the market, if that ever occurs.

@even sven

In the 80s, scientists were skeptical, and dismissed it out of hand (for malaria).

And your source for this claim is…?

[Agnostic_Pagan]

@Jackmannii

@Agnostic Pagan

I would think something this effective at treating cancer would be more widespread by now with pharma companies competing to see who could get a drug to market first.

Of course, Big Pharma has blocked it from getting to market so they can sell a slew of hugely expensive drugs that don’t work.

If that is how you interpret that statement, well… Big Pharma has blood on its hands, but not here. (And that is mostly from manipulating IP laws over existing products, but that topic is for GD) Whoever first brought an effective treatment to market would make some handsome profits, I think. I am certain they are watching developments closely, but do not see anything worth investing their own R&D on yet. I am wondering what that key step is, and why it has not been made.

From the link to the first abstract:

This study shows the potential use of artemisinin derivatives as therapeutic candidates for PCa and warrants the initiation of preclinical studies.

I do not know what they mean by preclinical, but I am guessing that is still in the petri dish stage. I had thought they had tested it on actual patients from reading the other abstract. As I said, the technical info in the actual articles are above my pay grade.

@dofe

When I used to work in pharma research, we had a class of compounds that appeared very promising during in vitro studies. We spent years going back and forth trying to find a compound that was in the sweet spot between efficacy and acceptable side effects. We simply were unable to overcome the side effects we saw during in vivo studies without losing the efficacy of the compound, however.

As others have already noted, there’s a big gulf between a compound that works in the lab versus a drug that is useful in a clinical setting.

Thank you. This is the type of answer I was looking for. I have no idea how difficult the process is to go from one stage to the other. I know it is common for promising research to go unfulfilled, but they look tantalizing close in this case, and hoped for more expertise on what their roadblocks are. After ten years, it is starting to look like they might be insurmountable.

even sven, your story about your experience in another thread was the only result of my search, and why I started this thread. I had hoped this topic had been covered before.

And** Derleth** I saw that info also (though from a different source,) and is partly why I did not link to the original article that suggested drinking tea would provide all the benefits needed. While that preparation might be effective in treating malaria (though not likely,) it highly increases the chances of incomplete treatment and creating more resistant strains of malaria. The sad part is I do not know how you could prevent it from occurring since the herb is so common.

[dofe]

@Agnostic_Pagan

Thank you. This is the type of answer I was looking for. I have no idea how difficult the process is to go from one stage to the other. I know it is common for promising research to go unfulfilled, but they look tantalizing close in this case, and hoped for more expertise on what their roadblocks are. After ten years, it is starting to look like they might be insurmountable.

We spent 4-5 years doing assays and in vivo studies on that particular class of compounds. During this time we published results from our studies in peer-reviewed journals and presented our findings at conferences. Unfortunately we were unable to get our candidate compounds into clinical studies. The research team slowly (and quietly) moved into other areas.

Negative results don’t get published.