Cough Medicine Ingredient Could Treat Prostate Cancer, Study Shows

By Wednesday, 31 December 2008 00:00

A laboratory study published December 18 in the December issue of the European medical journal Anticancer Research reports that an ingredient used in a common cough suppressant may be useful in treating advanced prostate cancer. Researchers found that noscapine, which has been used in cough medication for nearly 50 years, in mice reduced tumor growth by 60% and limited the spread of tumors by 65% without causing harmful side effects.

Noscapine is approved for use in some countries as a cough suppressant or available as an over the counter cough medicine, and Dr. Barken has prescribed it "off-label" to patients with prostate cancer.

However, patients who have taken noscapine in an effort to control prostate cancer do not appear to have benefited so far.

Noscapine, a naturally-occurring plant alkaloid, is a non-addictive derivative of opium. As a natural substance, noscapine cannot be patented, which has limited the potential for clinical trials. Drug companies are generally unwilling to underwrite expensive clinical trials without being able to recoup their investment. A synthetic analog of noscapine has been patented by Cougar Biotechnology as a chemotherapy drug and is in preclinical testing.

A problem that may arise with off-label prescription is lack of an adequate testing base from which to assess efficacy of the new use. The laboratory study of noscapine was a joint effort by Dr. Israel Barken of the Prostate Cancer Research and Educational Foundation, Moshe Rogosnitzky of MedInsight Research Institute, and Dr. Jack Geller of The University of California San Diego. They in 20 immune-suppressed (athymic) mice with PC3 prostate cancer cells. On day 10, when palpable tumors developed, 10 of the mice were left alone and 10 were treated daily with noscapine (300 mg/kg) diluted in water. "Treatments were continued for 56 days. Body weight was determined and tumors were measured before treatment and twice weekly after the initiation of treatment."

Results

"Lymphatic metastases were observed in 90% of the animals in the control group and 30% of the animals in the treated group," the authors write. "This finding suggests that daily, oral noscapine (300 mg/kg) may reduce or forestall the metastasis of prostate cancer to lymph nodes. However, the incidences of metastases to the lung were not significantly lower in the treated group than in the control group (treated 20% vs. control 30%). Nevertheless, total metastatic tumor weights were significantly lower in noscapine-treated mice."

Noscapine has previously been studied as a treatment for breast, ovarian, colon, lung and brain cancer and for various lymphomas, chronic lymphocytic leukemia and melanoma.

Dr. Barken used noscapine to treat a handful of prostate cancer patients before retiring from clinical practice. Encouraged by the success of these treatments, he explains, his foundation funded the laboratory study being reported in the December 2008 edition of Anticancer Research.

Since first presenting results of his laboratory study at a conference in Vail, CO in 2007, Dr. Barken, as director of the Prostate Cancer Research and Educational Foundation in San Diego, has been encouraging academic institutions to follow up this laboratory research with a human clinical trial. He has pioneered a web-based patient tracking system in hope of reducing the cost of such a trial while cutting the time necessary to complete the study. Using the web-based tracking system would alos, he says, allow doctors outside the U.S. to enroll patients in the research.

Rogosnitzky, director of research at MedInsight Research Institute, points out the significant advantages that noscapine could present as a treatment for prostate cancer. Noscapine, he says, does not have "the unpleasant side effects associated with other common prostate cancer treatments. Because noscapine has been used as a cough-suppressant for nearly half a century, it already has an extensive safety record. This pre-clinical study shows that the dose used to effectively treat prostate cancer in the animal model was also safe."In this laboratory study on mice, no toxic side effects were observed from the use of noscapine.

One patient who took noscapine in an effort to control his prostate cancer told psa-rising.com this week that his PSA rose above 200 while on the medication. The regular dose for noscapine when taken as a cough medicine is 50 mg. This patient was taking 2,500 mg (2 and a half grams) per day. He discontinued the treatment on developing mouth sores while seeing his PSA rise. Sinbce then, this patient said, he had switched to another meduication which has lowered his PSA to below 3 ng/ml.

Dr. Barken commented, "we need information about humans clinical studies. Unfortunately, there are none that I am aware."

In 2007 an Emory University laboratory study in collaboration with Nankai University, Tianjin, China reported that "p53 and p21 Determine the Sensitivity of Noscapine-Induced Apoptosis in Colon Cancer Cells."

A cautionary note - it has been reported (2008) that noscapine can increase the effect of warfarin, the blood thinner. Four cases have been reported of adverse interaction between noscapine at regular 50 mg dose x 3 and warfarin By February 2008 "11 cases of increased INR and 1 hemorrhage due to coadministration of warfarin and noscapine" had been reported to the Swedish drug informationsystem adverse drug reaction register. "An in vitro studysuggested that noscapine inhibits the warfarin-metabolizing enzymes CYP2C9 and CYP3A4. Coadministration of warfarin and noscapine should therefore be avoided."

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Cough Medicine Ingredient Could Treat Prostate Cancer, Study Shows

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