As a painkiller and heroin replacement, methadone is established worldwide. But can the artificially produced substance similar to opium even more? After controversial debates on methadone as a possible cancer remedy, its effect in tumor therapy is now being investigated for the first time in a clinical study.
Scientists at the University Hospital Ulm want to determine whether or not methadone in patients with advanced colorectal cancer is effective, as the German Cancer Aid announced. It supports the therapy study, which is scheduled to run until 2026, with 1.6 million euros.
In 2017, media reports had sparked hopes that the addition of methadone to cancer drugs would kill tumor cells. The assumption was based on experimental research by chemist Claudia Friesen of the Institute of Legal Medicine at the University of Ulm. In 2008, she concluded that blood cancer cells die more and lower their resistance to chemotherapy when treated with methadone. Later research with cell cultures of other tumors seemed to confirm the assumption.
Study to close research gap
After Friesen also reported on her experiments on television and other media, her critics accused her of "methadone hype." Emotional reports from patients who were still alive thanks to methadone fueled the controversy. It even went so far that physicians who did not want to prescribe methadone as a therapy, was accused of being bought by the pharmaceutical industry.
As a result, the German Medical Association emphasized that there are no reliable studies on the efficacy of methadone in cancer therapy. However, even more sophisticated reports of some life-threatening side effects of methadone, which were subsequently published, could not stem the rumor about the potency enhancement of the opioid.
The study at the Ulm University Hospital should now provide reliable answers. It involves patients with colorectal cancer who have already metastasized and hardly respond to chemotherapy. "Our hypothesis is that methadone makes the tumor sensitive to the chemotherapeutic agents again," said study leader Professor Thomas Seufferlein, medical director of the Department of Internal Medicine.
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Results for colon cancer only - not for other tumor types
Methadone may be able to dock with cancer cells and make sure "that the chemotherapy drugs are able to penetrate the cells better - the drugs are more effective," said Seufferlein. This must be examined open-ended.
In addition, results would apply only to the situation of advanced colon cancer and not to other types of tumors, and only to the specific chemotherapeutic agent and the specific dosage of methadone. "You can not generalize the results in one direction or the other."
The study is scheduled to start in the first quarter of 2020. In the longer term, Seufferlein expects about 30 patients to receive methadone in addition to chemotherapy, compared to others who are treated with chemotherapy and, if necessary, with morphine or other analgesics. First reliable results could be available at the earliest beginning of 2022.
The chairman of the German Cancer Aid, Gerd Nettekoven, pointed to a great public interest in the topic. "Therefore, we consider it important to study the potential of this drug under clinical conditions," he said.
Around 53,000 people had petitioned for further studies on the substance's effectiveness. In the Petitions Committee of the Bundestag, representatives of the Ministry of Research stated that the Federal Government was "open to the promotion of clinical studies on the use of methadone in cancer therapy". There is still no final decision on state funding.
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