Artemisinin: a new perspective for the treatment of viral infections and cancer

Artemisinin is a precious plant extract that has transformed how medicine works and will most certainly continue to do so.

Artemisinin was first isolated in the 1970s from Artemisia annua, a sweet Chinese wormwood plant. Afterwards, scientists have kept on discovering exciting clinical uses of Artemisinin. For example, Artemisinin was successfully licensed as the gold-standard anti-malarial drug that has saved millions of lives, even earning the discovering scientists a Nobel prize.

Now, the potent anti-cancer and anti-viral properties of Artemisinin are just being explored by scientists internationally, which this newsletter will further illuminate.

As Artemisinin is already anti-parasitic (malaria is caused by a parasite), scientists from the Netherlands were curious enough to test if Artemisinin is also anti-cancerous. In their 1993 publication, those scientists reported, for the first time, that Artemisinin-treated cancer cells had a 50-80% reduced growth rate compared to untreated cancer cells.

Since then, the scientific community has continued to see further publications substantiating the anti-cancer properties of Artemisinin:

• A 2008 clinical trial from China discovered that lung cancer patients who underwent combined Artemisinin and chemotherapy treatment had a 21% higher rate of disease stabilisation compared to chemotherapy alone.
• A 2015 clinical trial from the U.K. showed that cancer patients on oral Artemisinin were 80% less likely to experience recurrent colorectal cancer than the placebo group.
• A 2018 literature review noted that the anti-cancer effects of Artemisinin in laboratory-based settings (i.e., cells in culture plates or animals) are broad-ranging, encompassing blood, liver, gastric, lung, breast and prostate cancers, among others.
• A 2018 clinical trial from the U.S. reported that Artemisinin (injected into the vein) was safe and well-tolerated in a group of patients with solid (non-blood) cancers.
• A 2019 clinical trial from Germany showed that long-term (up to three years) intake of oral Artemisinin as a compassionate treatment had no major safety concerns in late-stage breast cancer patients.
• A 2020 clinical trial from the U.S. found that self-administered vaginal Artemisinin inserts were safe and efficacious in slowing disease progression in women at risk of cervical cancer.

Focusing on prostate cancer, Artemisinin is capable of degrading the androgen receptor to inhibit androgen signalling. Without androgens (i.e., a group of male hormones), the growth of prostate cancer cells would be greatly impeded. Androgen deprivation therapy is, therefore, the preferred treatment of advanced prostate cancer. Even in androgen-resistant prostate cancer cells, Artemisinin can re-sensitise them to depend on androgens – by impairing the androgen receptor variant 7 that sustains androgen resistance. In clinical settings, high-dose oral Artemisinin for 3-24 months has been deemed safe in prostate cancer patients, of which some patients also showed biochemical indications of suppressed cancer recurrence.

Emphasising on breast cancer, Artemisinin is also known to initiate self-destruction in cancer cells that typically have high iron levels due to their greater bioenergetic demands. For example, Artemisinin has been shown to react with iron to create high amounts of oxidative stress, which triggered an over 5-fold increase in breast cancer cell death in laboratory settings. This iron-dependent, oxidative stress-induced cell death is called ferroptosis. Clinically, at least four studies have used oral Artemisinin as a complementary therapy for advanced breast cancer patients (for up to three years) without any major safety issues.

Parasites are considered microbial, just like viruses. It is thus not far-fetched to speculate that Artemisinin could be anti-viral as well. Several studies have, indeed, verified this notion:

• A 2018 literature review informed that Artemisinin has anti-viral activities against the Ebola virus and various types of herpesviruses and hepatitis viruses in both laboratory and clinical settings.
• A 2021 study from Denmark and Germany found that Artemisinin successfully stopped SARS-CoV-2, the causative agent of COVID-19, from infecting mammalian cells at an efficacy of over 50% in laboratory settings.
• A 2021 clinical trial from China demonstrated that oral Artemisinin treatment hastened virus clearance time by 45% in COVID-19 patients compared to standard care.
• A 2022 study from the U.S. found that Artemisinin’s anti-viral effects against SARS-CoV-2 did not waver against its variants (i.e., Alpha, Beta, Gamma, Kappa and Delta).

Currently, the World Health Organisation’s (WHO) Solidarity clinical trial is testing the potential of Artemisinin as an anti-inflammatory agent in the treatment of COVID-19.

Therefore, the medical potential of Artemisinin is vast, extending beyond malaria to cancer and virology fields. The safety of Artemisinin has also been assured repeatedly ever since it was licensed as an anti-malarial treatment decades ago. The WHO has even deemed Artemisinin as ‘very safe’ in its Solidarity trial that seeks to find new COVID-19 treatments. In essence, Artemisinin provides extensive clinical benefits with practically no harm.