Recently a drug derived from a Chinese medicinal herb received international attention when it was covered in Time Magazine with the headline “Can Ancient Herbs Treat Cancer?”1 Ban Zhi Lian (BZL101) (Bionovo, Inc., Emeryville, California; NASDAQ: BNVI) is an aqueous extract from the aerial part of Scutellaria barbata, also known as barbed skullcap.2
Introduced by Bionovo, a drug development company with a focus on
cancer and women’s health, this herbal preparation began a Phase I
clinical trial in 2001 at Cancer Research Network in Plantation,
Florida. In this trial, 21 patients with stage 4 metastatic breast
cancer took 12 grams a day of BZL101 for a year. The results were that
4 of 16 patients (25%) had stabilization in their disease for 90s days,
and 3 of 16 patients (19%) had stabilization for 180 days. Five
patients had objective tumor regression, including one patient who had
a partial remission based on the study's modified response evaluation
criteria in solid tumors (RECIST).
BZL101 appears to work by singling out tumor cells. The drug makes
them undergo apoptosis, programmed cell death, by preventing cancer
cells from undergoing glycolysis, a process of glycogen breakdown
responsible for 85% of the cell’s energy.1,2 From the Phase
1 trial, the investigators concluded that BZL101 had a favorable
toxicity profile and further development for cancer is warranted.
“There has been a shift in the standards of metastatic breast cancer
treatment, as the oncology community moves to prescribing oral drugs at
a lower toxicity, for both efficacy and quality of life reasons,” wrote
Mary Tagliaferri, MD, president, co-founder and Chief Medical Officer
CMO of Bionovo (e-mail, December 6, 2007). “BZL101 would seem to fit
this new standard as an oral drug designed from the outset for minimal
side effects and proven favorable efficacy, even in a heavily
pretreated patient population.”
BZL101 is now undergoing a multi-center, Phase 1 & 2,
open-label, non-randomized, dose escalation trial to assess safety,
feasibility, optimal dosing and preliminary efficacy of BZL101 at 9
clinical sites throughout the United States, according to Katherina
Audley, director of corporate media and communications at Bionovo
(e-mail, December 6, 2007) and Bionovo’s Web site.3 The next
trial is slated to enroll 80 women with breast cancer, 40 who are
estrogen receptor positive and (ER+), and 40 who are negative (ER-).
In general medical research, Phase I clinical trials address the
safety and tolerability of a drug and determine the maximum tolerated
dose or the appropriate biological active dose. Phase II clinical
trials focus on determining a drug’s efficacy; however, in cancer
research Phase I trials can also measure efficacy as an outcome in a
descriptive fashion.
Charlotte Gyllenhaal, PhD, Research Assistant Professor at the
University of Illinois at Chicago at Chicago and associate editor of Integrative Cancer Therapies,
a peer-reviewed journal dealing with non-conventional cancer treatments
(e-mail, December 5, 2007) states: “It is certainly a breakthrough in
cancer research for a company to be testing an herbal extract for its
cancer treatment properties, since herbs may eventually turn out to be
easier to tolerate than pure compound anticancer drugs.” (Gyllenhaal is
also a member of the American Botanical Council Advisory Board.) “This
is a breakthrough that was made possible by the FDA’s new Botanical
Drug classification, and it is great to see that in action in the
cancer area.” Dr. Gyllenhaal was referring to the FDA guidance document
that establishes FDA policy in addressing botanicals as drugs in the
United States.4
More information about BZL101 is available at http://www.bzl101.com/ and http://www.bionovo.com/.
—Kelly E. Saxton
References
1Carr C. Can ancient herbs treat cancer? Time Magazine. October 15, 2007; 170(16). Available at http://www.time.com/time/health/article/0,8599,1671684,00.html?cnn=yes. Accessed October 26, 2007. 2Rugo
H, Shtivelman E, Perez A, Vogel C, Franco S, Tan Chiu E, Melisko M,
Tagliaferri M, Cohen I, Shoemaker M, Tran Z, Tripathy D. Phase I trial
and antitumor effects of BZL101 for patients with advanced breast
cancer. Breast Cancer Res Treat. September 2007;105(1):17-28. Available
at http://www.bionovo.com/media/mediaarchives/Bionovo_Breast_Cancer_Research_Treatment.pdf. Accessed November 1, 2007. 3Bionovo. Clinical programs page. Bionovo. Available at http://bionovo.com/home.php?menu=clinicalprograms&submenu=BZL101. Accessed January 8, 2008. 4Food
and Drug Administration, Center for Drug Evaluation and Research.
Guidance for Industry: Botanical Drug Products [Chemistry]. June 2004.
Available at www.fda.gov/cder/guidance/index.htm. Accessed January 8, 2008. |