Scabraside D from Holothuria scabra Induces Apoptosis and Inhibits Growth of Human Cholangiocarcinomas in Mice

Cholangiocarcinoma (CCA), is an incurable cancer of the biliary epithelium, and is an important public health problem in many Asian countries (Sripa and Pairojkul, 2008; Shin et al., 2010; Sripa et al., 2011). High prevalence is found in northeast Thailand, where people eat raw freshwater fish infested with Opisthorchis viverrini, the parasitic platyhelminth associated with CCA (Haswell-Elkins et al., 1994). Among the treatment regime of CCA is chemotherapy by 5-fluorouracil (5-FU), which however is rather ineffective (Hejna et al., 1998). The combined treatment of CCA with chemotherapy and radiotherapy causes severe adverse effects without significantly improving the prognosis of a patient (Sirica, 2005). Therefore, for this and other types of incurable cancer, alternative treatments without adverse effects have been widely sought after. Various extracts from natural products, especially from marine plants and animals,