Universidade Federal de Santa Maria, Programa de Pós-graduacão Em Ciências Farmacêuticas, Santa Maria, RS, Brazil; and.
Departamento de Análises Clínicas e Toxicológicas, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
Am J Ther. 2021;28(1):e111-e117. doi: 10.1097/MJT.0000000000000906.
The worldwide increase in the occurrence of cancer associated with the limitations of immunotherapy and the emergence of resistance have impaired the prognosis of cancer patients, which leads to the search for alternative treatment methods. Drug repositioning, a well-established process approved by regulatory agencies, is considered an alternative strategy for the fast identification of drugs, because it is relatively less costly and represents lower risks for patients.
We report the most relevant studies about drug repositioning in oncology, emphasizing that its implementation faces financial and regulatory obstacles, making the creation of incentives necessary to stimulate the involvement of the pharmaceutical industry.
We present 63 studies in which 52 non-anticancer drugs with anticancer activity against a number of malignancies are described.
Some have already been the target of phase III studies, such as the Add-Aspirin trial for nonmetastatic solid tumors, as well as 9 other drugs (aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, ritonavir, and sertraline) in the CUSP9* clinical trial for the treatment of recurrent glioblastoma. Others have already been successful in repositioning such as thalidomide, zoledronic acid, celecoxib, methotrexate, and gemcitabine.
Therefore, drug repositioning represents a promising alternative for the treatment of oncological disorders; however, the support from funding agencies and from the government is still needed, the latter regarding regulatory issues.
全球癌症发病率的增加,加上免疫疗法的局限性和耐药性的出现,影响了癌症患者的预后,这促使人们寻求替代治疗方法。药物重定位是一种已被监管机构批准的成熟过程,被认为是快速识别药物的替代策略,因为它相对成本较低,对患者的风险较低。
我们报告了肿瘤学中药物重定位的最相关研究,强调其实施面临财务和监管障碍,因此有必要创造激励措施来刺激制药行业的参与。
我们介绍了 63 项研究,其中描述了 52 种具有抗癌活性的非抗癌药物,针对多种恶性肿瘤。
其中一些已经成为 III 期研究的目标,例如非转移性实体瘤的 Add-Aspirin 试验,以及其他 9 种药物(阿瑞匹坦、青蒿琥酯、金诺芬、卡托普利、塞来昔布、双硫仑、伊曲康唑、利托那韦和舍曲林)在 CUSP9*临床试验中用于治疗复发性胶质母细胞瘤。其他药物如沙利度胺、唑来膦酸、塞来昔布、甲氨蝶呤和吉西他滨已经成功实现了药物重定位。
因此,药物重定位是治疗肿瘤疾病的一种很有前途的替代方法;然而,仍然需要来自资助机构和政府的支持,后者需要解决监管问题。