Arsenic trioxide as a novel anti-glioma drug: a review
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ellular & Molecular Biology Letters
Open Access
REVIEW LETTER
Arsenic trioxide as a novel anti‑glioma drug: a review Yi Fang and Zhen Zhang* *Correspondence: [email protected] Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, People’s Republic of China
Abstract Arsenic trioxide has shown a strong anti-tumor effect with little toxicity when used in the treatment of acute promyelocytic leukemia (APL). An effect on glioma has also been shown. Its mechanisms include regulation of apoptosis and autophagy; promotion of the intracellular production of reactive oxygen species, causing oxidative damage; and inhibition of tumor stem cells. However, glioma cells and tissues from other sources show different responses to arsenic trioxide. Researchers are working to enhance its efficacy in anti-glioma treatments and reducing any adverse reactions. Here, we review recent research on the efficacy and mechanisms of action of arsenic trioxide in the treatment of gliomas to provide guidance for future studies. Keywords: Arsenic trioxide, Glioma, Anti-cancer mechanism
Introduction Glioma is the most common primary malignant tumor of the central nervous system, accounting for about 50–60% of intracranial tumors. Its invasion and recurrence rates are significantly higher than those of other intracranial tumors [1]. Due to its invasive growth, it generally cannot be completely surgically removed [2]. Despite advances in clinical treatment methods, the prognosis for patients remains poor [3]. New therapeutic strategies, including novel drugs, are needed to effectively inhibit the proliferation, invasion and metastasis of glioma cells and treat this malignant cancer type. Elemental arsenic is insoluble in water and acid. It has almost no toxicity, but when exposed to air, it readily oxidizes to highly toxic arsenic trioxide. Traditional Chinese medicine has applied arsenic and arsenic-containing medicines to treat a variety of intractable diseases since ancient times [4], but the toxicity has limited its medical applications. Recent studies have shown that arsenic trioxide has an inhibitory effect on acute promyelocytic leukemia (APL), a hematological tumor, and on solid tumors including liver [5], lung [6] and breast cancer [7]. In glioma, arsenic trioxide exerts its anti-cancer effects via regulation of apoptosis and autophagy; its impact on the cell cycle; promotion of the production of intracellular reactive oxygen species (ROS), which results in oxidative damage; inhibition of tumor stem cells; and enhancement of the effects of radiotherapy and chemotherapy. However,
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