This prescription drug is used off-label in low doses to treat people with cancer, with notable but very preliminary successes in cases where the cancers were difficult-to-treat or quite advanced.

Are you a health professional?

This section does not replicate the other information on this topic but provides additional details or context most relevant to professionals.

Modes of action: opioid receptors

Opioid receptors are involved in tumor growth, angiogenesis, and immunosuppression 1Carli M, Donnini S, Pellegrini C, Coppi E, Bocci G. Opioid receptors beyond pain control: The role in cancer pathology and the debated importance of their pharmacological modulation. Pharmacological Research. 2020 Sep;159:104938. Naltrexone has been found to prevent angiogenesis, although at modest magnitudes.2Zagon IS, McLaughlin PJ. Opioids and the apoptotic pathway in human cancer cells. Neuropeptides. 2003 Apr;37(2):79-88. 

Low-dose naltrexone upregulates the expression of opioid growth factor receptor (OGFr) and OGFr antagonist, apparently suppressing colony formation, migration, and invasion in cervical cancer cells.3Liu N, Yan L et al. Low-dose naltrexone plays antineoplastic role in cervical cancer progression through suppressing PI3K/AKT/mTOR pathway. Translational Oncology. 2021 Apr;14(4):101028; Couto RD, Fernandes BJD. Low doses naltrexone: the potential benefit effects for its use in patients with cancer. Current Drug Research Reviews. 2021 Jan 26; Ma M, Wang X, Liu N, Shan F, Feng Y. Low-dose naltrexone inhibits colorectal cancer progression and promotes apoptosis by increasing M1-type macrophages and activating the Bax/Bcl-2/caspase-3/PARP pathway. International Immunopharmacology. 2020 Jun;83:106388. Naltrexone acts on all opioid receptors, blocking the interaction between OGF and OGFr.4Wang R, Zhang Y, Shan F. Interaction of opioid growth factor (OGF) and opioid antagonist and their significance in cancer therapy. International Immunopharmacology. 2019 Oct;75:105785.

Preclinical evidence 

Notable preclinical evidence is listed here; clinical evidence is in How can low-dose naltrexone help you? What the research says ›

Improving treatment outcomes

Breast cancer
Colorectal cancer
Gynecological cancer
Head and neck cancer
Neuroblastoma
  • Lower tumor incidence, longer delays until tumor appearance, and increased survival time among neuroblastoma-inoculated mice receiving 0.1 mg of naltrexone per kilogram per day, compared to 10 milligrams of naltrexone per kilogram per day in a preclinical trial11Zagon IS, McLaughlin PJ. Naltrexone modulates tumor response in mice with neuroblastoma. Science. 1983 Aug;221:671-673.
Ovarian cancer
  • Repressed tumor progression in mice with established ovarian tumors with LDN in combination with cisplatin but not taxol in preclinical studies12Donahue RN, McLaughlin PJ, Zagon IS. Low-dose naltrexone suppresses ovarian cancer and exhibits enhanced inhibition in combination with cisplatin. Experimental Biology and Medicine (Maywood). 2011 Jul;236(7):883-95.
  • Reduced tumor nodule number and weight in mice with transplanted  human ovarian cancer with either opioid growth factor or LDN compared to placebo13Donahue RN, McLaughlin PJ, Zagon IS. The opioid growth factor (OGF) and low dose naltrexone (LDN) suppress human ovarian cancer progression in mice. Gynecologic Oncology. 2011 Aug;122(2):382-8.
Pancreatic cancer
  • In mice, pancreatic cancer treated with both naltrexone and tramadol was more invasive than pancreatic cancer treated with tramadol alone14Kuramochi T, Sano M, Kajiwara I, Oshima Y, Itaya T, Kim J, Ichimaru Y, Kitajima O, Masamune A, Ijichi H, Suzuki T. Effects of tramadol via a µ-opioid receptor on pancreatic ductal adenocarcinoma in vitro and in vivo. Regional Anesthesia and Pain Medicine. 2024 Mar 4;49(3):200-208.

Optimizing your body terrain

Inflammation
Immune function

Managing side effects and promoting wellness

Body composition
  • Less weight loss associated with cisplatin in animals when LDN was added to treatment in a preclinical trial20Donahue RN, McLaughlin PJ, Zagon IS. Low-dose naltrexone suppresses ovarian cancer and exhibits enhanced inhibition in combination with cisplatin. Experimental Biology and Medicine (Maywood). 2011 Jul;236(7):883-95.
Quality of life

Helpful links for professionals

Keep reading about low-dose naltrexone

Authors

Sophie Kakarala

Research Assistant
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Sophie received her Bachelor of Arts from the University of Cambridge, where she studied Middle Eastern languages and the philosophy of science. She then completed a premedical post-baccalaureate at the City University of New York. Before joining CancerChoices, she worked for several years at the Cornell Center for Research on End-of-Life Care, where she helped to conduct research on terminal illness and grief. Working in end-of-life research filled her with the conviction that all patients deserve free, accessible, and scientifically accurate information about the therapies available to them. While taking classes in anthropology, she also became curious about traditional medical knowledge and philosophies. These interests led her to CancerChoices. She is delighted to be part of CancerChoices’s work creating rigorous, evidence-based treatment guides for patients and physicians.

Sophie Kakarala Research Assistant

Nancy Hepp, MS

past Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS past Lead Researcher

Reviewers

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Alissa Huston received her medical degree at the University of Buffalo, and went on to complete an Internal Medicine residency at Strong Memorial Hospital. She then attended the University of Pittsburgh for her Hematology/Oncology fellowship, during which time she was involved in research involving bone metastasis in cancer.

Currently, she is an Associate Professor of Medicine at the Wilmot Cancer Institute at the University of Rochester, where her clinical efforts are focused on breast cancer. She is also the Co-Medical Director of the Pluta Integrative Oncology & Wellness Center. Her research efforts focus on understanding the effects of treatment for breast cancer upon bone health and how integrative modalities can help mitigate symptoms for cancer patients as they undergo treatment.

She is a member of the American Society of Clinical Oncology and the Society for Integrative Oncology. Her philosophy is that there is no singular approach to patient care. Even though many patients may carry the same diagnosis, each individual is affected by that illness in a different way. Patients are not perceived as just a number, but instead approached and treated as the unique individuals they represent.

Alissa Huston, MD

Last update: July 27, 2025

Prior update: May 20, 2022

Full literature review dates: July 2025, September 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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