title: Trial watch: Cardiac glycosides and cancer therapy.
abstract: Cardiac glycosides (CGs) are natural compounds sharing the ability to operate as potent inhibitors of the plasma membrane Na+/K+-ATPase, hence promoting-via an indirect mechanism-the intracellular accumulation of Ca2+ions. In cardiomyocytes, increased intracellular Ca2+concentrations exert prominent positive inotropic effects, that is, they increase myocardial contractility. Owing to this feature, two CGs, namely digoxin and digitoxin, have extensively been used in the past for the treatment of several cardiac conditions, including distinct types of arrhythmia as well as contractility disorders. Nowadays, digoxin is approved by the FDA and indicated for the treatment of congestive heart failure, atrial fibrillation and atrial flutter with rapid ventricular response, whereas the use of digitoxin has been discontinued in several Western countries. Recently, CGs have been suggested to exert potent antineoplastic effects, notably as they appear to increase the immunogenicity of dying cancer cells. In this Trial Watch, we summarize the mechanisms that underpin the unsuspected anticancer potential of CGs and discuss the progress of clinical studies that have evaluated/are evaluating the safety and efficacy of CGs for oncological indications.
authors.affiliation: Institut Gustave Roussy; Villejuif, France ; Université Paris-Sud/Paris XI; Le Kremlin-Bicêtre, France ; INSERM; U848; Villejuif, France.
authors.forename: Laurie
authors.initials: L
authors.lastname: Menger
authors.forename: Erika
authors.initials: E
authors.lastname: Vacchelli
authors.forename: Oliver
authors.initials: O
authors.lastname: Kepp
authors.forename: Alexander
authors.initials: A
authors.lastname: Eggermont
authors.forename: Eric
authors.initials: E
authors.lastname: Tartour
authors.forename: Laurence
authors.initials: L
authors.lastname: Zitvogel
authors.forename: Guido
authors.initials: G
authors.lastname: Kroemer
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Galluzzi
keywords: Digitalis purpurea; breast carcinoma; estrogen receptor; immunogenic cell death; ouabain; phytoestrogens