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Zeitschrift für Phytotherapie 2024; 45(01): 15-21
DOI: 10.1055/a-2255-7611
Forschung

Artemisia annua und Artesunat in der Onkologie

Artemisia annua und artesunate in oncology
Thomas Efferth
1   Institut für Pharmazeutische und Biomedizinische Wissenschaften, Johannes Gutenberg-Universität Mainz
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ZUSAMMENFASSUNG

Artesunat ist ein klinisch etabliertes Medikament zur Malariabehandlung. Präklinische Daten weisen darauf hin, dass Artesunat und Artemisinin, die Leitsubstanz aus der chinesischen Heilpflanze Artemisia annua L., auch gegen Krebs eingesetzt werden könnten.

Im Allgemeinen wurden Artemisinin und Artesunat nach den bisher vorliegenden klinischen Befunden gut vertragen, wobei vereinzelt immer wieder auch signifikante Nebenwirkungen wie Hämatotoxizität, Hepatotoxizität oder Neurotoxizität auftraten. Auf das Vorkommen schwerer Nebenwirkungen muss auch weiterhin besonderes Augenmerk gelegt werden, insbesondere wenn Artesunat zusammen mit anderen Medikamenten verabreicht wird.

Die veterinärmedizinischen Studien zeigen, dass spontane Tiertumoren nicht nur ein interessantes Modell für die Translation präklinischer Daten in die Klinik sind, sondern dass Artesunat- und Artemisia-annua-Präparate eine neue Behandlungsoption für Haustiere mit Tumorerkrankungen darstellen könnten.

Die Wirksamkeit von Artesunat gegen verschiedene solide humane Tumoren ist bisher als eher mäßig einzustufen, wobei das Zervixkarzinom möglicherweise besser anzusprechen scheint. Insgesamt liegen noch zu wenige Daten vor, um die klinischen Ansprechraten bei verschiedenen Tumortypen zuverlässig beantworten zu können. Weitere größere klinische Phase-II- und -III-Studien sind nötig.

Abstract

Artesunate is a clinically established medicament for the treatment of malaria. Preclinical data indicates that artesunate and artemisinin, the lead substances from the Chinese medicinal plant Artemisia annua L., also have the potential of being used against cancer. Generally, artemisinin and artesunate have been well tolerated according to the clinical findings available to date, although significant side effects such as haematotoxicity, hepatotoxicity or neurotoxicity have occurred in isolated cases. Particular attention must continue to be paid to the occurrence of serious side effects, especially when artesunate is administered in combination with other medications. Veterinary studies show that spontaneous animal tumours offer an interesting model for the translation of preclinical data to the clinic. In this regard, artesunate and Artemisia annua preparations have the possibility of representing a new treatment option for pets with tumour diseases. However, the efficacy of artesunate against various solid human tumours has hitherto been classified as relatively modest; with cervical carcinoma possibly responding better. Overall, there is still insufficient data available to be able to reliably draw inferences about the clinical response rates in different tumour types. Further larger Phase II and III clinical trials are therefore required.

Key words

Chemotherapy - molecular pharmacology - natural products - rational phytotherapy - sesquiterpenoids - traditional Chinese medicine


Publication History

Article published online:
26 February 2024

© 2024. Thieme. All rights reserved.

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