Schulich School of Medicine, Western University, London, ON, Canada.
Bloor Pain Specialists, Toronto, ON, Canada.
Adv Ther. 2021 Feb;38(2):904-924. doi: 10.1007/s12325-020-01591-9. Epub 2020 Dec 18.
Naltrexone (NTX) is an opioid antagonist traditionally used as a treatment for alcohol and opioid use disorders, but various studies have documented its involvement in cancer progression, exploring possible anticancer potential, when administered at high doses or as low dose naltrexone (LDN). Herein we present a systematic review of cancer-related outcomes from case reports, clinical trials, and retrospective and prospective studies conducted using cell cultures, animal models, and human subjects receiving NTX/LDN.
A systematic search of NTX in cancer therapy was conducted. Outcomes including tumor size and number, latency to tumor development, survival duration, progression of disease, and scan results were assessed in clinical and animal studies, and cell number was used as the outcome measure of culture studies.
Several case reports demonstrate notable survival durations and metastatic resolutions in patients with late stage cancer when administered an average LDN dose of 3-5 mg/day. Animal and cell culture studies suggest an overarching principle of NTX involvement in cancer pharmacophysiology, suggesting that high doses and continuous administration can foster cancer progression, whereas low doses and intermittent treatment may hinder cell proliferation, impede tumorigenesis, and have potential anticancer efficacy.
This review emphasizes the value of potential future research on NTX in cancer therapy, and warrants need for a better understanding of underlying mechanisms. Future controlled studies with more robust sample sizes, particularly in humans, are needed to fully elucidate its potential in cancer therapy.
纳曲酮(NTX)是一种阿片类拮抗剂,传统上用于治疗酒精和阿片类药物使用障碍,但各种研究都记录了它在癌症进展中的作用,探索了高剂量或低剂量纳曲酮(LDN)给药时的潜在抗癌作用。本文系统回顾了使用细胞培养物、动物模型和接受 NTX/LDN 的人类受试者进行的病例报告、临床试验以及回顾性和前瞻性研究中与癌症相关的结果。
对 NTX 在癌症治疗中的应用进行了系统搜索。在临床和动物研究中,评估了包括肿瘤大小和数量、肿瘤发展潜伏期、生存时间、疾病进展和扫描结果在内的结果,在培养研究中,细胞数量用作结果衡量指标。
几项病例报告表明,晚期癌症患者接受平均 3-5mg/天的 LDN 剂量治疗后,存活时间和转移性缓解显著。动物和细胞培养研究表明,NTX 参与癌症药理生理学的一个总体原则是,高剂量和连续给药可能促进癌症进展,而低剂量和间歇性治疗可能会抑制细胞增殖、阻碍肿瘤发生,并具有潜在的抗癌功效。
本文强调了未来在癌症治疗中研究 NTX 的价值,并需要更好地了解其潜在机制。需要进行更多具有更大样本量的对照研究,特别是在人类中,以充分阐明其在癌症治疗中的潜力。