Berger Thomas G, Dieckmann Detlef, Efferth Thomas, Schultz Erwin S, Funk Jens-Oliver, Baur Andreas, Schuler Gerold
Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany.
Oncol Rep. 2005 Dec;14(6):1599-603.
Artesunate (ART) is a derivative of artemisinin, the active principle of the Chinese herb Artemisia annua L. Artesunate is approved for the treatment of multidrug-resistant malaria and has an excellent safety profile. It has been shown that Artesunate, apart from its anti-malarial activity, has cytotoxic effects on a number of human cancer cell lines, including leukemia, colon cancer and melanoma. We report on the first long-term treatment of two cancer patients with ART in combination with standard chemotherapy. These patients with metastatic uveal melanoma were treated on a compassionate-use basis, after standard chemotherapy alone was ineffective in stopping tumor growth. The therapy-regimen was well tolerated with no additional side effects other than those caused by standard chemotherapy alone. One patient experienced a temporary response after the addition of ART to Fotemustine while the disease was progressing under therapy with Fotemustine alone. The second patient first experienced a stabilization of the disease after the addition of ART to Dacarbazine, followed by objective regressions of splenic and lung metastases. This patient is still alive 47 months after first diagnosis of stage IV uveal melanoma, a situation with a median survival of 2-5 months. Despite the small number of treated patients, ART might be a promising adjuvant drug for the treatment of melanoma and possibly other tumors in combination with standard chemotherapy. Its good tolerability and lack of serious side effects will facilitate prospective randomized trials in the near future.
青蒿琥酯（ART）是青蒿素的衍生物，青蒿素是中药黄花蒿的活性成分。青蒿琥酯被批准用于治疗耐多药疟疾，且具有良好的安全性。研究表明，青蒿琥酯除了具有抗疟活性外，对多种人类癌细胞系，包括白血病、结肠癌和黑色素瘤细胞系，均具有细胞毒性作用。我们报告了首例用青蒿琥酯联合标准化疗对两名癌症患者进行长期治疗的情况。这两名转移性葡萄膜黑色素瘤患者在单独使用标准化疗无法阻止肿瘤生长后，在同情用药的基础上接受了治疗。该治疗方案耐受性良好，除了单独使用标准化疗所引起的副作用外，没有其他额外的副作用。一名患者在单独使用福莫司汀治疗疾病进展时，加用青蒿琥酯后出现了短暂缓解。第二名患者在加用青蒿琥酯至达卡巴嗪后，疾病首先出现稳定，随后脾脏和肺部转移灶出现客观缓解。该患者在首次诊断为IV期葡萄膜黑色素瘤后47个月仍然存活，而该疾病的中位生存期为2 - 5个月。尽管治疗的患者数量较少，但青蒿琥酯可能是一种有前景的辅助药物，可与标准化疗联合用于治疗黑色素瘤以及可能的其他肿瘤。其良好的耐受性和缺乏严重副作用将有助于在不久的将来开展前瞻性随机试验。
