What is Ukrain?
Ukrain (NSC-631570) is a semisynthetic compound of thiophosphoric acid [triaziridide] and the alkaloid chelidonine derived from the common weed, greater celandine (Chelidonium majus L.), which grows primarily in Europe and Asia (ref 1). Ukrain is not a licensed drug in any of the EU countries. Information is lacking regarding the purity of the preparation.
Description of treatment method
Ukrain is most commonly administered intravenously. It is claimed that it consists of one molecule of thiophosphoric acid conjugated to three molecules of chelidonine.
History / providers
Ukrain was developed in 1978 by Dr. Wassyl J. Nowicky, director of the Ukrain Anti-Cancer Institute of Vienna, Austria and first presented at the 13th International Congress of Chemotherapy in Vienna in August 1983. Extracts from Chelidonium majus were traditionally used for liver and gallbladder complaints, loss of appetite and gastroenteritis, although none of these indications are supported by trial evidence. Chelidonium majus contains a range of alkaloids, most notably chelidonine, also known as benzophenanthridine alkaloid, chelidoxanthine and coptisine. Chelidonine has antispasmodic, weak central analgesic and papaverine-like effects. Greater celandine extracts have been shown to stimulate production of bile and pancreatic digestive enzymes in human studies (ref 2). The manufacturers of Ukrain are Nowicky Pharma, A-1040, Vienna, Austria.
Claims of efficacy / mechanisms of action / alleged indication
""Various claims of efficacy of Ukrain exist, which have so far not been backed up by compelling scientific evidence"
"
Several reports describe Eastern European clinical trials using Ukrain for people with various types of cancer (ref 3). These findings cannot be applied to greater celandine because the alkaloids have been modified from their original form. The mechanism of action of Ukrain is unknown.
Various claims of efficacy of Ukrain exist, which have so far not been backed up by compelling scientific evidence. For instance, the producer of Ukrain states that:
- It is toxic against cancer cells at the therapeutic dose but not against healthy cells.
- It accumulates at the site of the tumour very rapidly after injection and brings about the encapsulation of larger tumours through anti-angiogenesis, thereby increasing operability.
- It regenerates the immune system.
Antineoplastic and immunomodulatory effects have been suggested. For instance it has been suggested that the alkaloids interfering with the metabolism of cancer cells diminish synthesis of DNA, RNA and proteins. It has also been suggested that cellular oxygen consumption may be inhibited and thus a programmed cell death of malignant cells is thought to be induced (ref 4).
Prevalence of use
No data exist to estimate the prevalence of use of Ukrain by cancer patients.
Legal issues
In the UK, the Medicines and Healthcare products Regulatory Agency states that, if a company places a manufactured herbal remedy on the market or supplies the product to herbalists, such a product needs to have either a marketing authorisation or traditional-use registration (http://www.mhra.gov.uk/). This is in accordance with the new European Directives and Regulation of herbs. Ukrain is not FDA-approved in the US but has drug licenses in several states of the former Soviet Union. According to the German BfArM, Ukrain has no drug approval in Germany and the EU (http://www.bfarm.de/de/Presse/mitteil_2001/index.php?more=0116.php)
Costs and expenditures
The costs of Ukrain therapy are high; one course costs €700 for the medication alone, and the total treatment costs have been estimated at €3,000 per week (ref 21).
For ten injections of 10-20 mg intravenously the total cost of medication itself is approximately $3,500.00 (€2,891). This includes shipping, handling, bank transfer and prescription.
References
1. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1985, 84–8.
2. Baumann JC. Effect of Chelidonium, Curcuma, absinth and Carduus marianus on the bile and pancreatic secretion in liver diseases. Med Monatsschr 1975;29:173–80 [in German].
3. Susak YM, Zemskov VS, Yaremchuk OY, et al. Comparison of chemotherapy and x-ray therapy with Ukrain monotherapy for colorectal cancer. Drugs Exptl Clin Res 1996;22:115–22.
4. Jagiello-Wojtowicz E, Kleinrok Z, Urbanska EM. Ukrain (NSC-631570) in experimental and clinical studies: a review. Drugs Exp Clin Res 1998;24:213-9.
21. Hopf G. Ukrain® - Fortschritt oder Rückschritt in der medikamentösen Therapie onkologischer Erkrankungen? Deutsche Zeitschrift für Onkologie 2002;34:31-6.
