Koltai Tomas, Fliegel Larry
Hospital del Centro Gallego de Buenos Aires, Buenos Aires 2199, Argentina.
Department of Biochemistry, University Alberta, Edmonton, AB T6G 2H7, Canada.
Pharmaceuticals (Basel). 2024 Jun 6;17(6):744. doi: 10.3390/ph17060744.
Rarely has a chemical elicited as much controversy as dichloroacetate (DCA). DCA was initially considered a dangerous toxic industrial waste product, then a potential treatment for lactic acidosis. However, the main controversies started in 2008 when DCA was found to have anti-cancer effects on experimental animals. These publications showed contradictory results in vivo and in vitro such that a thorough consideration of this compound's in cancer is merited. Despite 50 years of experimentation, DCA's future in therapeutics is uncertain. Without adequate clinical trials and health authorities' approval, DCA has been introduced in off-label cancer treatments in alternative medicine clinics in Canada, Germany, and other European countries. The lack of well-planned clinical trials and its use by people without medical training has discouraged consideration by the scientific community. There are few thorough clinical studies of DCA, and many publications are individual case reports. Case reports of DCA's benefits against cancer have been increasing recently. Furthermore, it has been shown that DCA synergizes with conventional treatments and other repurposable drugs. Beyond the classic DCA target, pyruvate dehydrogenase kinase, new target molecules have also been recently discovered. These findings have renewed interest in DCA. This paper explores whether existing evidence justifies further research on DCA for cancer treatment and it explores the role DCA may play in it.
很少有化学物质像二氯乙酸(DCA)那样引发如此多的争议。DCA最初被认为是一种危险的有毒工业废品,后来又被视为乳酸酸中毒的一种潜在治疗方法。然而,主要的争议始于2008年,当时发现DCA对实验动物具有抗癌作用。这些出版物在体内和体外显示出相互矛盾的结果,因此有必要对该化合物在癌症治疗中的作用进行全面考量。尽管经过了50年的实验,但DCA在治疗领域的未来仍不确定。在没有充分的临床试验和卫生当局批准的情况下,DCA已在加拿大、德国和其他欧洲国家的替代医学诊所被用于未经批准的癌症治疗。缺乏精心规划的临床试验以及非医学专业人员对其的使用,使得科学界对其兴趣不大。关于DCA的全面临床研究很少,许多出版物都是个别病例报告。最近,关于DCA抗癌益处的病例报告不断增加。此外,研究表明DCA可与传统治疗方法及其他可重新利用的药物协同作用。除了经典的DCA靶点丙酮酸脱氢酶激酶外,最近还发现了新的靶点分子。这些发现重新激发了人们对DCA的兴趣。本文探讨现有证据是否足以证明对DCA进行癌症治疗的进一步研究是合理的,并探讨了DCA可能在其中发挥的作用。