Methadone a new possible treatment for leukemia

Methadone, a drug used to treat people addicted to heroin and other opioid drugs, holds promise as a new treatment for leukemia, especially treatment-resistant leukemia, according to results of a study.

Laboratory tests show that methadone kills leukemia cells without harming healthy blood cells, researchers at the University of Ulm in Germany report in a paper published today in the journal Cancer Research. Methadone was even effective in killing leukemia cells resistant to killing by chemotherapy and radiation.

"Leukemia cells express opioid receptors, to which methadone binds," study chief Dr. Claudia Friesen told Reuters Health. "Surprisingly, we found that methadone kills leukemia cells efficiently. We never expected that."

These results "provide the foundation for new strategies using methadone as an additional anticancer drug in leukemia therapy, especially when conventional therapies are less effective," the investigators conclude.

"We find this very exciting, because once conventional treatments fail, which occurs in old and also in young patients, they have no other options," Friesen said.

She predicts that methadone will have similar effects in other cancers that express opioid receptors. "In our lab we found that we also can kill solid tumors," she added.

Friesen and her team are studying methadone alone and in combination with other chemotherapy drugs in animal models of cancer.

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Unnecessary chemotherapy for leukemia patients

Nearly one-third of leukemia patients do not respond to chemotherapy, but this is not typically discovered until they have already endured a week-long course of chemotherapy and waited even longer to see if the chemotherapy worked.

A new study shows that positron emission tomography, known as PET scans, may tell doctors how well a leukemia patient is responding after just one day of chemotherapy.

"This has very profound implications for patients," Dr. Matt Vanderhoek told Reuters Health. "Instead of making the patient go through a week of chemotherapy only to find out after the fact that their chemotherapy wasn't successful, therapy could be modified and changed on the fly."

The University of Wisconsin researcher will present the research Thursday at the 50th annual meeting of the American Association of Physicists in Medicine, underway in Houston, Texas.

Treating leukemia typically involves killing the cancer cells where they originate in the bone marrow. Doctors traditionally take a bone marrow biopsy up to a week after the end of chemotherapy to see how well the cancer-killing drugs have worked.

"The problem with the bone marrow biopsy is that it is an insensitive and weak predictor of treatment response," Vanderhoek said. "A lot of patients will be told that their treatment was successful when in fact it wasn't. As a result you have a patient who has undergone a week of chemotherapy only to find out much later on that their treatment was unsuccessful."

In eight patients with a type of leukemia called acute myeloid leukemia (AML) undergoing a standard 7-day course of chemotherapy, Vanderhoek's team found that a PET scan using a PET radio-tracer called FLT obtained after only one day of chemotherapy can indicate whether or not the patient is responding to chemotherapy.

According to Vanderhoek and colleagues, brightness and non-uniformity in the bone marrow FLT PET scan was an indication that the patient was not responding to chemotherapy.

"We hope that this data will provide enough evidence for a larger study to reach more definitive conclusions" on the value of FLT PET in determining response to chemotherapy in leukemia patients, Vanderhoek said.

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