While outside the label of medicines can be controversial in political media, in science and health they lead to important profits. A new example is the drug digoxin of heart disease used in a low and safe dose for a week for nine metastatic breast cancer patients.
The number of cancer cells per group decreased significantly, by an average of 2.2 cells. That is significant because typical cluster sizes are just a handful of cells, which could lead to a significant reduction in the risk of metastasis. Breast cancer is an example of a tumor that spreads by releasing blood cancer cells. These circulating tumor cells are joined in small groups of up to a dozen cells and are established in other organs, where they grow in larger tumors: metastasis. Metastatic tumors caused around seven million deaths every year.
Digoxin probably works because OT blocks sodium potassium pumps found in tumor cell membranes and are responsible for the transport of sodium outside the cells and potassium in them. By suppressing that ion exchange, the cells absorb more calcium from the outside of the cell membrane that weakens the cohesion of cancer cells in the group, which makes them fall apart.
toStudy flow chart. bRepresentative images of a single CTC and homotypic and heterotypic CTC groups (scale bar, 10 µm), dyed with EPCAM, HER2 and EGFR (green) and CD45 (magenta). do,dLME random coefficients that show a negative association between the treatment and the average size of all CTC groups (do) and between homotypic (regression coefficient −0.20, 95% IC −0.76 to 0.35) or heterotypical (regression coefficient −0.31, 95% IC −1.21 to 0.59), separately (separately (d). LME coefficients are also shown for non -random control patients, do not receive digoxin therapy (regression coefficient 0.48, 95% IC −0.10 to 1.07 for homotypic groups; regression coefficient −0.06, 95% IC −0.70 to 0.58 for heterotypic clusters). The crossed bar in d represents the fixed effect coefficient LME. myThe average size of the cluster at the beginning and the post -treatment (day 3 or day 7) matched by the patient (north = 9). The boxes represent the lower, medium and superior quantile. Vertical lines show the range of values, and gray lines connect paired values. P The values were calculated using the unilateral pairingT -proof. FThe change in average CTC cluster size fold after pretreatment in treated patients. In control patients, the change in the average size of the CTC cluster is shown on day 3 or day 7 (depending on the size of the smallest cluster) on the start. Each point represents an individual patient, and the crossbar represents the median. P The values were calculated using the unilateral Wilcoxon range sum test. gramNegative association between digoxin levels and the standardized size of CTC groups on day 7 (linear regression P = 0.14, β= −4.65). The points represent individual patients, the line represents the linear regression model and the shaded area represents the 95% IC of the tight line. CTCAE, common terminology criteria for adverse events; Bm, bone marrow; ECG, electrocardiogram; SAE, serious adverse event. Panelto It was created withBiorender.com.
What has to happen then is that something matches cancer cells. Digoxin can’t do that.
However, digoxin alone does not eliminate the existing tumor. The agent would have to be administered in combination with other substances that kill existing cancer cells.
Next, the researchers want to develop new molecules based on digoxin that improve their ability to dissolve CTC groups. The authors also wish to expand work to other types of cancer that propagate, such as prostate, colorectal or pancreatic, and melanoma cancer. The initial experiments in their laboratory have already begun.
Reference: Kurzede C, Nguyen-Sträuli BD, Krol I, Ring A, et al. Digoxin for the reduction of the circulating size of the tumor cell group in metastatic breast cancer: a concept test study. Nature Medicine2025. DOI: 10.1038/S41591-024-03486-6
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