Artemisinin and Artesunate in Cancer Research

Artemisinin is a malaria medicine drawn from sweet wormwood, a Chinese herb, and artesunate is the water-soluble drug made from it that is now the standard injection for severe malaria. Both have been studied against cancer cells for more than twenty years. This page sets one point from a 2026 integrative-oncology presentation — that artemisinin and artesunate belong among the antiparasitic drugs with anti-cancer research behind them — beside the published research: which plant the drug really comes from, what the laboratory work shows, what the small human trials have reported, and what is known about harm.


Table of Contents

  1. What the Presentation Said
  2. Sweet Wormwood and Common Wormwood: Two Different Plants
  3. From an Old Herbal Text to a Nobel Prize
  4. Intravenous Artesunate for Severe Malaria
  5. Iron, Free Radicals and Ferroptosis in the Laboratory
  6. What Human Cancer Trials Have Reported
  7. Artesunate Applied to Human Papillomavirus Precancers
  8. Trials Registered on ClinicalTrials.gov
  9. Delayed Haemolysis and Other Reported Harms
  10. How the Claim Compares With the Research
  11. What Is Not Known
  12. Connections
  13. Key Research Papers
  14. Featured Videos

What the Presentation Said

Artemisinin came up briefly, in a passage about antiparasitic medicines being repurposed for cancer. After discussing mebendazole, fenbendazole and ivermectin, the speaker said that a lot of research has been done on antiparasitic drugs against cancer, listing ivermectin, the benzimidazole family, and “artemisinin, which is wormwood”, together with artesunate.

The speaker then said that the clinic gives artesunate for cancer intravenously (into a vein) and that patients tolerate it very well. Before this list, the speaker had described three general ways antiparasitic drugs are thought to act on tumours: changing tumour signalling, disrupting the cell's internal scaffolding (microtubules), and affecting the immune system and the tissue around a tumour.

No study of artemisinin or artesunate in cancer was named, no cancer type, dose or schedule was given, and no outcome figures were presented for this drug. The presentation moved straight on to the quinine family and then to ivermectin. This page therefore tests three things the presentation said or implied: that artemisinin “is wormwood”, that there is a body of anti-cancer research on these drugs, and that intravenous artesunate is very well tolerated.

Sweet Wormwood and Common Wormwood: Two Different Plants

“Wormwood” is a common name shared by several plants of the genus Artemisia, and the two most often confused are quite different herbs.

Saying that artemisinin “is wormwood” therefore blurs two points. Artemisinin is a single purified compound, not a plant. And the plant it is taken from is sweet wormwood, not the common wormwood sold as an absinthe or digestive herb.

The picture is not completely black and white. A laboratory survey of fifteen Artemisia species growing in northern Pakistan measured artemisinin by high-performance liquid chromatography. It found the highest levels in the leaves (0.44%) and flowers (0.42%) of sweet wormwood. Common wormwood was among ten species with much lower levels, in the range of 0.05% to 0.15% (Mannan and colleagues, 2010). That survey reported, in the same paper, that drug artemisinin is obtained from Artemisia annua. A common-wormwood tea or tincture is a different product from the purified drug, with a different chemistry, including the thujone that sweet wormwood is not known for.

Neither herb is the same as artesunate. Artesunate is a semi-synthetic derivative: chemists start from artemisinin and modify it so it dissolves in water and can be injected (Wang and colleagues, 2024).

From an Old Herbal Text to a Nobel Prize

By the late 1960s, malaria parasites had become resistant to chloroquine and quinine across much of the world. According to the Nobel Committee's press release, Tu Youyou, working in China, turned to traditional herbal medicine and screened herbal remedies in malaria-infected animals. An extract of Artemisia annua stood out, but its results were inconsistent. She went back to the ancient literature, found clues on how to extract the active component, and was the first to show that this component, later named artemisinin, was highly effective against the malaria parasite in infected animals and in people.

The 2015 Nobel Prize in Physiology or Medicine was divided: one half to William C. Campbell and Satoshi Ōmura for the roundworm drug that became ivermectin, and the other half to Tu Youyou “for her discoveries concerning a novel therapy against Malaria”. The press release states that artemisinin used in combination therapy is estimated to reduce malaria deaths by more than 20% overall and by more than 30% in children. Tu Youyou published her own account of the discovery in 2011 (Tu, 2011).

The prize was awarded for malaria. Neither the Nobel citation nor the press release mentions cancer.

Intravenous Artesunate for Severe Malaria

Intravenous artesunate is not an experimental drug. In severe malaria it is the treatment the major guidelines use first, and it earned that place in two large randomised trials against the older injectable drug, quinine.

The two large trials

The United States label

The U.S. Food and Drug Administration (FDA) approved artesunate for injection in 2020 (the label states “Initial U.S. Approval: 2020”). The label indicates it for the initial treatment of severe malaria in adults and children, always followed by a full course of an oral antimalarial. The labelled dose is 2.4 mg per kg intravenously at 0, 12 and 24 hours, then once a day. A review of malaria care in the US describes intravenous artesunate as first-line therapy for severe malaria (Daily and colleagues, 2022).

The label has no cancer indication. Every use of artesunate against cancer, by any route, is outside its approval and is the subject of research rather than an established treatment.

Iron, Free Radicals and Ferroptosis in the Laboratory

Artemisinin's structure contains an unusual “peroxide bridge”, two oxygen atoms bonded to each other inside the molecule, which reviews describe as essential to its activity (Hu and colleagues, 2022). When this bridge meets iron, it breaks apart and releases reactive molecules (free radicals) that damage nearby proteins and fats. Malaria parasites live inside red blood cells and digest haemoglobin, which is rich in iron, so the drug is activated exactly where the parasite lives.

Cancer researchers noticed that many cancer cells also take up more iron than normal cells, and asked whether artemisinin could exploit the same weakness. Reviews of the laboratory literature describe many proposed effects on tumour cells: oxidative stress, DNA damage, cell-cycle arrest, blocking the growth of new blood vessels (angiogenesis), interference with growth-signalling pathways, and several forms of cell death (Efferth, 2017).

Ferroptosis

Ferroptosis is a form of programmed cell death that is driven by iron and by the oxidation of the fats in cell membranes (lipid peroxidation). Several reviews now treat artemisinin and its derivatives as ferroptosis inducers (Wang and colleagues, 2024).

These are laboratory findings, in cells and in mice. They explain why researchers became interested, but they do not show that the drug shrinks tumours or extends life in people. A major review called artemisinin-type drugs “at the stairways to the clinics” — that is, still at the early clinical stage (Efferth, 2017).

What Human Cancer Trials Have Reported

A systematic review of artesunate outside malaria, covering studies in people from 2008 to 2017, concluded that the studies did not settle whether artesunate or related drugs work against cervical, breast, colorectal or lung cancer, and that further human trials were needed (Raffetin and colleagues, 2018). The individual trials below are small and early-phase.

Colorectal cancer before surgery (oral artesunate)

A single-centre, randomised, double-blind, placebo-controlled pilot trial in the United Kingdom gave 23 patients awaiting surgery for bowel cancer either 14 daily doses of oral artesunate (200 mg) or a placebo (Krishna and colleagues, 2015). Twenty patients completed the trial as planned.

That larger trial (NeoART) is described in the ClinicalTrials.gov section below; no results from it were found.

Metastatic breast cancer (oral artesunate added to standard treatment)

An open, uncontrolled phase I study in Germany gave 23 women with metastatic breast cancer 100, 150 or 200 mg of oral artesunate a day for four weeks, on top of their guideline-based cancer treatment (von Hagens and colleagues, 2017). Three patients had six dose-limiting adverse events possibly related to artesunate (low white-cell counts, low neutrophils, weakness and anaemia). The authors judged up to 200 mg a day safe and well tolerated for further trials. The study measured safety, not whether the cancer shrank. A separate hearing study within the same trial recorded four patients with possibly related ear symptoms and four with vertigo, one classed as serious, which resolved after the drug was stopped (König and colleagues, 2016).

Advanced solid tumours (intravenous artesunate)

The only intravenous cancer trial found was a phase I dose-escalation study in the United States in 19 patients with advanced solid tumours who had already received other treatment (Deeken and colleagues, 2018). Artesunate was given on days 1 and 8 of a 21-day cycle at doses from 8 to 25 mg per kg — several times the 2.4 mg per kg malaria dose.

Artesunate Applied to Human Papillomavirus Precancers

The most active area of human research is not swallowed or injected artesunate at all, but artesunate placed directly on precancerous lesions caused by human papillomavirus (HPV). These are changes in the lining of the cervix, vulva or anus (graded 2 or 3 when more advanced) that can progress to cancer. In this setting the drug is used to make abnormal tissue regress, which is different from treating an established cancer.

These results come from small, uncontrolled phase I studies. A randomised, placebo-controlled phase II trial in the United States (listed below) is the study designed to show whether the regression rates are due to the drug.

Trials Registered on ClinicalTrials.gov

A search of ClinicalTrials.gov for “artesunate cancer” (October 2026) returned 27 records, several of them malaria or COVID-19 studies. The cancer and precancer studies are listed below with their status as recorded on the registry. A status of “unknown” means the record has passed its expected completion date without being verified by the sponsor for more than two years.

Cancer

Human Papillomavirus precancers

No registered trial of intravenous artesunate for cancer beyond the completed phase I study was found, and no randomised trial of any form of artemisinin has reported a survival result in cancer.

Delayed Haemolysis and Other Reported Harms

Artesunate has an excellent record in short courses for malaria, but the research describes harms that matter more when it is used in higher doses, for longer, or outside its approved setting.

Post-artesunate delayed haemolysis

Haemolysis means the breakdown of red blood cells. After intravenous artesunate for severe malaria, some patients develop anaemia one to three weeks later, after the infection itself has cleared.

In the Benin study, children with delayed haemolysis had higher levels of “pitted” red blood cells — infected cells from which the spleen has removed a drug-damaged parasite — and all the adult cases at the Spanish centre had very heavy infections, which ties the effect to malaria itself. Whether anything similar happens in people without malaria who take artesunate for cancer has not been studied in the same way.

Other reported harms

Decisions about cancer treatment and antiparasitic medicines belong with a clinician.

How the Claim Compares With the Research

Supported

Supported only in part

Contradicted

No research found

What Is Not Known

Connections

Key Research Papers

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  2. Mannan A, Ahmed I, Arshad W, et al. Survey of artemisinin production by diverse Artemisia species in northern Pakistan. Malaria Journal. 2010;9:310. PubMed PMID: 21047440
  3. Lachenmeier DW, Walch SG, Padosch SA, Kröner LU. Absinthe--a review. Critical Reviews in Food Science and Nutrition. 2006;46(5):365-77. PubMed PMID: 16891209
  4. Dondorp A, Nosten F, Stepniewska K, et al. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet. 2005;366(9487):717-25. PubMed PMID: 16125588
  5. Dondorp AM, Fanello CI, Hendriksen IC, et al. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet. 2010;376(9753):1647-57. PubMed PMID: 21062666
  6. Daily JP, Minuti A, Khan N. Diagnosis, Treatment, and Prevention of Malaria in the US: A Review. JAMA. 2022;328(5):460-471. PubMed PMID: 35916842
  7. Efferth T. From ancient herb to modern drug: Artemisia annua and artemisinin for cancer therapy. Seminars in Cancer Biology. 2017;46:65-83. PubMed PMID: 28254675
  8. Wang Y, Yuan X, Ren M, Wang Z. Ferroptosis: A New Research Direction of Artemisinin and Its Derivatives in Anti-Cancer Treatment. The American Journal of Chinese Medicine. 2024;52(1):161-181. PubMed PMID: 38328829
  9. Hu Y, Guo N, Yang T, et al. The Potential Mechanisms by which Artemisinin and Its Derivatives Induce Ferroptosis in the Treatment of Cancer. Oxidative Medicine and Cellular Longevity. 2022;2022:1458143. PubMed PMID: 35028002
  10. Chen GQ, Benthani FA, Wu J, et al. Artemisinin compounds sensitize cancer cells to ferroptosis by regulating iron homeostasis. Cell Death and Differentiation. 2020;27(1):242-254. PubMed PMID: 31114026
  11. Zhu L, Tan Q, Wang Y, et al. Artemisitene triggers calcium-dependent ferroptosis by disrupting the LSH-EWSR1 interaction in colorectal cancer. Redox Biology. 2026;89:103950. PubMed PMID: 41337810
  12. Raffetin A, Bruneel F, Roussel C, et al. Use of artesunate in non-malarial indications. Medecine et Maladies Infectieuses. 2018;48(4):238-249. PubMed PMID: 29422423
  13. Krishna S, Ganapathi S, Ster IC, et al. A Randomised, Double Blind, Placebo-Controlled Pilot Study of Oral Artesunate Therapy for Colorectal Cancer. EBioMedicine. 2015;2(1):82-90. PubMed PMID: 26137537
  14. von Hagens C, Walter-Sack I, Goeckenjan M, et al. Prospective open uncontrolled phase I study to define a well-tolerated dose of oral artesunate as add-on therapy in patients with metastatic breast cancer (ARTIC M33/2). Breast Cancer Research and Treatment. 2017;164(2):359-369. PubMed PMID: 28439738
  15. König M, von Hagens C, Hoth S, et al. Investigation of ototoxicity of artesunate as add-on therapy in patients with metastatic or locally advanced breast cancer: new audiological results from a prospective, open, uncontrolled, monocentric phase I study. Cancer Chemotherapy and Pharmacology. 2016;77(2):413-27. PubMed PMID: 26793976
  16. Deeken JF, Wang H, Hartley M, et al. A phase I study of intravenous artesunate in patients with advanced solid tumor malignancies. Cancer Chemotherapy and Pharmacology. 2018;81(3):587-596. PubMed PMID: 29392450
  17. Trimble CL, Levinson K, Maldonado L, et al. A first-in-human proof-of-concept trial of intravaginal artesunate to treat cervical intraepithelial neoplasia 2/3 (CIN2/3). Gynecologic Oncology. 2020;157(1):188-194. PubMed PMID: 32005582
  18. Michener CM, Ricci S, AlHilli M, et al. Safety and efficacy of topical artesunate for the treatment of vulvar intraepithelial neoplasia 2/3. Gynecologic Oncology. 2023;178:102-109. PubMed PMID: 37839312
  19. Sadana A, Guliam A, Opiyo EA, et al. “When a Thorn Comes Into Your Body, You Must Remove It”. A Socio-Ecological Analysis of the Acceptability of Intravaginal Artesunate as Cervical Precancer Treatment in a Phase 1 Clinical Trial. International Journal of Women's Health. 2026;18:573262. PubMed PMID: 42403515
  20. Sadana A, Omoto J, Sorgi K, et al. Feasibility of Intravaginal Artesunate as an Adjuvant HPV & Cervical Precancer Treatment Among Women Living With HIV in Kenya: Study Protocol for a Phase II Clinical Trial. Cancer Control. 2025;32:10732748251374418. PubMed PMID: 40907021
  21. Aldámiz-Echevarría Lois T, López-Polín A, Norman FF, et al. Delayed haemolysis secondary to treatment of severe malaria with intravenous artesunate: Report on the experience of a referral centre for tropical infections in Spain. Travel Medicine and Infectious Disease. 2017;15:52-56. PubMed PMID: 27818359
  22. Carret V, Sossou D, Yakoubou A, et al. Post-artesunate Delayed Hemolysis in African Children With Severe Malaria: Incidence, Medical Impact and Prevention. Clinical Infectious Diseases. 2025;81(2):389-396. PubMed PMID: 39964912

PubMed Topic Searches

  1. Artesunate in cancer: clinical trials
  2. Artemisinin and ferroptosis in cancer
  3. Artesunate for HPV precancers (intraepithelial neoplasia)
  4. Post-artesunate delayed haemolysis

Other Sources

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