Antagonists of the Mu-Opioid Receptor in the Cancer Patient: Fact or Fiction?

Curr Oncol Rep. 2022 Oct;24(10):1337-1349. doi: 10.1007/s11912-022-01295-z. Epub 2022 Jun 1.

Abstract

Purpose of review: Antagonists of mu-opioid receptor role in cancer progression remains to be elucidated. The objective of this review was to summarize the available evidence on antagonists of mu-opioid receptor effect on tumor progression and prognosis in different types of cancers and an evaluation of the available findings on their mechanism of action.

Recent findings: We have found studies related to methylnaltrexone (MNTX) and naltrexone (NTX) usage in cancer outcomes-related setting. We found consistent preclinical evidence of a potential action of MNTX and NTX on cancer growth and spread mediated mainly by effect on the opioid growth factor receptor (OGFr) axis, which results in depressed cell replication. However, clinical results are scarce and limited to poor-quality evidence. Further high-quality studies are warranted to study antagonists of mu-opioid receptor role as a therapeutic option in different types of cancer, especially in patients where the classical treatment causes unacceptable side effects.

Keywords: Cancer; Cancer growth; Low-dose naltrexone; Methylnaltrexone; Mu-opioid receptor (MOR); Naltrexone; Opioid growth factor (OGF); Opioid growth factor receptor (OGFr); PAMORAs; Peripheral antagonists of mu-opioid receptor; Tumor progression.

Publication types

  • Review

MeSH terms

  • Cell Proliferation
  • Humans
  • Naltrexone / analogs & derivatives
  • Narcotic Antagonists* / pharmacology
  • Narcotic Antagonists* / therapeutic use
  • Neoplasms* / drug therapy
  • Neoplasms* / metabolism
  • Quaternary Ammonium Compounds
  • Receptors, Opioid / metabolism

Substances

  • Narcotic Antagonists
  • Quaternary Ammonium Compounds
  • Receptors, Opioid
  • methylnaltrexone
  • Naltrexone