Drug repurposing in oncology: a path beyond the bottleneck.

IF 3.5 4区 医学 Q2 ONCOLOGY
Neha Sajwani, G P Suchitha, T S Keshava Prasad, Shobha Dagamajalu
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Abstract

Cancer is a major worldwide health burden, with rising incidence and mortality rates highlighting the critical need for more effective and accessible treatment alternatives. Conventional drug development is often hindered by long timelines, high prices, and significant failure rates, making it unable to fulfil the rapidly increasing therapeutic demands. In this context, drug repurposing, identifying new therapeutic applications for existing medications with proven safety profiles, has emerged as a potential and cost-effective alternative to traditional drug discovery. Although numerous studies have explored the anticancer prospects of repurposed drugs, there exists a lack of systematic and cumulative knowledge regarding the varied therapeutic classes of interest for oncological purposes. This is critical as a deeper understanding of mechanisms, discovery methods, and translational challenges would significantly boost the clinical use of repurposed drugs. This review provides an overview of ongoing drug repurposing activity in anticancer therapy, targeting diverse therapeutic groups like cardiovascular, antibacterial, antiviral, anti-inflammatory, antidepressant, and antipsychotic drugs. It highlights approved drugs such as metformin, which acts on the AMPK/mTOR pathway to suppress cancer cell proliferation, thalidomide, which is approved for use in multiple myeloma because it has antiangiogenic and immunomodulatory effects, and propranolol, which inhibits β-adrenergic signaling, suppressing VEGF-induced angiogenesis in breast and ovarian cancer. Drugs such as statins, sertraline, and ribavirin target different pathways like HMG-CoA reductase, autophagy regulation, and eIF4E inhibition, respectively. Regulatory pathways like the FDA's 505(b)(2) process, orphan drug status, and approaches for overcoming intellectual property issues are discussed. Through the convergence of mechanistic insight and clinical and regulatory perspectives, drug repurposing is a pragmatic approach to expand oncologic therapeutic options and promote bench-to-bedside translation. It also addresses major issues within this context, including tumor heterogeneity, regulatory barriers, and translational gaps, restricting clinical acceptance of repurposed drugs. Through the examination of these aspects, the potential of drug repurposing as an innovative strategy in oncology is shown to offer efficient, cost-effective, and rapidly deployable therapy. These options can enhance patient outcomes and change the future of cancer treatment.

肿瘤药物再利用:突破瓶颈之路。
癌症是世界范围内的一个主要健康负担,发病率和死亡率不断上升,突出表明迫切需要更有效和更容易获得的治疗方法。传统药物的开发常常受到时间长、价格高和失败率高的阻碍,使其无法满足迅速增长的治疗需求。在这种情况下,药物再利用,即确定现有药物的新治疗应用,已成为传统药物发现的潜在和具有成本效益的替代方案。尽管许多研究已经探索了重新用途药物的抗癌前景,但对于肿瘤学目的的各种治疗类别,仍然缺乏系统和累积的知识。这是至关重要的,因为对机制、发现方法和转化挑战的更深入了解将显著促进再用途药物的临床应用。本文综述了抗癌治疗中正在进行的药物再利用活动,针对不同的治疗群体,如心血管、抗菌、抗病毒、抗炎、抗抑郁和抗精神病药物。它强调了已批准的药物,如二甲双胍,它作用于AMPK/mTOR途径来抑制癌细胞增殖,沙利度胺,被批准用于多发性骨髓瘤,因为它具有抗血管生成和免疫调节作用,以及普萘洛尔,抑制β-肾上腺素能信号,抑制vegf诱导的乳腺癌和卵巢癌血管生成。他汀类、舍曲林和利巴韦林等药物分别针对HMG-CoA还原酶、自噬调节和eIF4E抑制等不同途径。本文讨论了监管途径,如FDA的505(b)(2)流程、孤儿药状态和克服知识产权问题的方法。通过机制洞察与临床和监管观点的融合,药物再利用是一种实用的方法,可以扩大肿瘤治疗选择并促进从实验室到床边的转化。它还解决了这一背景下的主要问题,包括肿瘤异质性、监管障碍和翻译差距,限制了临床对重新用途药物的接受。通过对这些方面的研究,药物再利用作为一种肿瘤学创新策略的潜力被证明可以提供高效、经济、快速部署的治疗。这些选择可以提高病人的治疗效果,改变癌症治疗的未来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medical Oncology
Medical Oncology 医学-肿瘤学
CiteScore
4.20
自引率
2.90%
发文量
259
审稿时长
1.4 months
期刊介绍: Medical Oncology (MO) communicates the results of clinical and experimental research in oncology and hematology, particularly experimental therapeutics within the fields of immunotherapy and chemotherapy. It also provides state-of-the-art reviews on clinical and experimental therapies. Topics covered include immunobiology, pathogenesis, and treatment of malignant tumors.
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