Abstract and key points
- Artemisia annua is a plant containing chemical compounds considered to have anti-cancer activity.
- There is currently no evidence in humans to support the use of A. annua against cancer.
- Artemisia annua is generally considered to be safe but cases of severe adverse effects with higher doses have been reported.
Artemisia annua L. is a common type of wormwood that belongs to the family of the Asteraceae. It is native to temperate Asia but naturalized throughout the world.
Artemisinin is an ingredient of A. annua. Artemesin and its semi-synthetic artemisinin derivatives (including dihydroartemisinin, artesunate, artemether and arteether) are used for the production of combination therapies for treatment of malaria (ACTs = Artemisinin-based Combination Therapy).
Animal studies suggested that artemisinin and related compounds inhibit tumour growth and metastasis. However, there is no evidence from clinical trials at the moment that the anticancer effects from animal studies translate into benefits for cancer patients. No clinical trials of A. annua and only one randomised clinical trial of artesunate are available.
Experiences from malaria treatment indicate a good tolerability of artemisinin-based drugs. However, there are two case reports with severe adverse effects when artemisinin-based drugs were used at higher doses.
CitationKlara Rombauts, Arne Heyerick, CAM-Cancer Consortium. Artemisia annua [online document]. http://www.cam-cancer.org/CAM-Summaries/Herbal-products/Artemisia-annua. August 21, 2013.
Summary assessed as up to date in August 2013 by Barbara Wider.
Summary fully revised and updated in August 2012 by Klara Rombauts.
Summary first published in March 2011, authored by Klara Rombauts and Arne Heyerick.
- Wikipedia, the free encyclopedia 2012. Available from: URL: http://en.wikipedia.org/wiki/Artemisia_annua, accessed 27 July 2012.
- Bhakuni, R.S., Jain D.C., Sharma, Kumar. Secondary metabolites of Artemisia annua and their biological activity. Current Science, 2001 Jan 10;80(1):35-48.
- Carbonara T, Pascale R, Argentieri MP, Papadia P, Fanizzi FP et al. Phytochemical analysis of a herbal tea of Artemisia annua L. J Pharm Biomed Anal 2012;62:79-86.
- Iqbal S, Younas U, Chan KW, Zia-Ul-Haq M, Ismail M. Chemical composition of Artemisia annua L. leaves and antioxidant potential of extracts as a function of extraction solvents. Molecules 2012;17:6020-6032.
- Weathers PJ, Towler MJ. The flavonoids casticin and artemetin are poorly extracted and are unstable in an Artemisia annua tea infusion. Planta Med 2012;78(10):1024-6.26. McGovern PE, Christofidou-Solomidou M, Wang W, Dukes F, Davidson T and El-Deiry WS. Anticancer activity of botanical compounds in ancient fermented beverages (review). Int J Oncol 2010;37:5-14.
- Natural Standard. Monograph on Artemisia annua. Natural Standard 2010Available from: URL: www.naturalstandard.com, accessed 27 July 2012.
- World Health Organization. WHO monograph on good agricultural and collection practices (GACP) for Artemisia annua L. 2006.
- McGovern PE, Christofidou-Solomidou M, Wang W, Dukes F, Davidson T, El-Deiry WS. Anticancer activity of botanical compounds in ancient fermented beverages (review). Int J Oncol. 2010 Jul;37(1):5-14.
- van Agtmael MA, Eggelte TA, van Boxtel CJ. Artemisinin drugs in the treatment of malaria: from medicinal herb to registered medication. Trends Pharmacol Sci 1999 May;20(5):199-205.
- Firestone GL, Sundar SN. Anticancer activities of artemisinin and its bioactive derivatives. Expert Rev Mol Med 2009;11:e32.
- Efferth T. Molecular pharmacology and pharmacogenomics of artemisinin and its derivatives in cancer cells. Curr Drug Targets 2006 Apr;7(4):407-21.
- Li LN, Zhang HD, Yuan SJ, Yang DX, Wang L, Sun ZX. Differential sensitivity of colorectal cancer cell lines to artesunate is associated with expression of beta-catenin and E-cadherin. Eur J Pharmacol 2008 Jun 24;588(1):1-8.
- Huang XJ, Ma ZQ, Zhang WP, Lu YB, Wei EQ. Dihydroartemisinin exerts cytotoxic effects and inhibits hypoxia inducible factor-1alpha activation in C6 glioma cells. J Pharm Pharmacol 2007 Jun;59(6):849-56.
- Li LN, Zhang HD, Yuan SJ, Tian ZY, Wang L, Sun ZX. Artesunate attenuates the growth of human colorectal carcinoma and inhibits hyperactive Wnt/beta-catenin pathway. Int J Cancer 2007 Sep 15;121(6):1360-5.
- Chen HH, Zhou HJ, Wu GD, Lou XE. Inhibitory effects of artesunate on angiogenesis and on expressions of vascular endothelial growth factor and VEGF receptor KDR/flk-1. Pharmacology 2004 May;71(1):1-9.
- Zhai DD, Supaibulwatana K, Zhong JJ. Inhibition of tumor cell proliferation and induction of apoptosis in human lung carcinoma 95-D cells by a new sesquiterpene from hairy root cultures of Artemisia annua. Phytomedicine 2010;17:856-861.
- Efferth T, Herrmann F, Tahrani A, Wink M. Cytotoxic activity of secondary metabolites derived from Artemisia annua L. towards cancer cells in comparison to its designated active constituent artemesinin. Phytomedicine 2011;18(11):959-969.
- Memorial Sloan Kettering Cancer Center. MSKCC summary on Artemisia annua L. Memorial Sloan Kettering Cancer Center 2010Available from: URL: http://www.mskcc.org/mskcc/html/69126.cfm, accessed July 2012.
- Singh NP and Lai H. Selective cytotoxicity of dihydroartemisinin and holotransferrin toward human breast cancer cells. Life Sci 2001;70(1):49-56.
- Singh NP and Lai H. Synergistic cytotoxicity of artemesinin and sodium butyrate on human cancer cells. Anticancer Res 2005;25:4325-4332.
- Zhang ZY, Yu SQ, Miao LY, Huang XY, Zhang XP, Zhu YP, et al. [Artesunate combined with vinorelbine plus cisplatin in treatment of advanced non-small cell lung cancer: a randomized controlled trial]. Zhong Xi Yi Jie He Xue Bao 2008 Feb;6(2):134-8.
- Singh N.P., Verma K.B. Case report of a laryngeal squamous cell carcinoma treated with artesunate. Archive of Oncology 2002;10(4):279-80.
- Berger TG, Dieckmann D, Efferth T, Schultz ES, Funk JO, Baur A, et al. Artesunate in the treatment of metastatic uveal melanoma--first experiences. Oncol Rep 2005 Dec;14(6):1599-603.
- Singh NP, Panwar VK. Case report of a pituitary macroadenoma treated with artemether. Integr Cancer Ther 2006 Dec;5(4):391-4.
- Campos S, de la Cerda P, Rivera A. Fatal artesunate toxicity in a child. Journal of Pediatric Infectious Diseases 2008;3(1):69-75.
- Panossian LA, Garga NI, Pelletier D. Toxic brainstem encephalopathy after artemisinin treatment for breast cancer. Ann Neurol 2005 Nov;58(5):812-3.
- Gordi T, Lepist EI. Artemisinin derivatives: toxic for laboratory animals, safe for humans? Toxicol Lett 2004 Mar 1;147(2):99-107.
- Shen M, Ge HL, He YX, Song QL, Zhang HZ. Immunosuppressive action of Qinghaosu. Sci Sin B 1984 Apr;27(4):398-406.
- Brinker F. Herb Contraindictions and Drug Interactions. Ecletic Medical Publications 2001
- Skyles AJ, Sweet BV. Alternative therapies. Wormwood. Am J Health Syst Pharm 2004 Feb 1;61(3):239-42.
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