Kristjansen Karoline Assifuah, Djebbara-Bozo Nulvin, Nanthan Kumanan Rune, Bønnelykke-Behrndtz Marie Louise
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Department of Plastic and Breast Surgery, Aalborg University Hospital, Søndre Skovvej 3, 9000, Aalborg, Denmark.
J Cancer Res Clin Oncol. 2025 May 9;151(5):157. doi: 10.1007/s00432-025-06185-y.
Drug repurposing may be an efficient strategy for identifying new cancer treatments. Tranexamic acid (TXA), an antifibrinolytic agent that affects the plasminogen-plasmin pathway, may have potential anticancer effects by influencing tumor cell proliferation, angiogenesis, inflammation, immune response, and tissue remodeling-all crucial processes contributing to tumor progression and metastasis.
Evaluate TXA's anticancer effects across in vitro, animal, and clinical studies to assess its potential as a repurposed cancer drug.
The study was designed as a PRISMA-compliant systematic review and meta-analysis. The literature search was conducted in MEDLINE, EMBASE, Web of Science, and the Cochrane Library. In vitro, animal, and clinical studies investigating the anticancer effects of TXA or epsilon-aminocaproic acid (EACA) were included. Animal and clinical studies were critically appraised, and studies with a low risk of bias were included in the meta-analysis.
Of 4367 identified records, 38 articles were included, collectively reporting findings from 41 in vitro studies, 34 animal studies (n = 843 animals), and seven clinical studies (n = 91 patients). The meta-analysis included nine animal studies and showed a tumor growth reduction in animals treated with TXA compared to controls with a standardized mean difference of - 1.0 (95%CI - 1.5; - 0.4) (p = 0.0002). Equivalently, the majority of in vitro studies reported reduced proliferation, viability, and invasiveness in TXA-exposed tumor cell lines. The clinical studies were considerably susceptible to bias, rendering any conclusions futile.
TXA shows promise as a repurposed cancer drug, revealing an overall reduction in tumor growth, viability, and invasiveness in animal and in vitro studies.
药物重新利用可能是识别新型癌症治疗方法的有效策略。氨甲环酸（TXA）是一种影响纤溶酶原 - 纤溶途径的抗纤维蛋白溶解剂，可能通过影响肿瘤细胞增殖、血管生成、炎症、免疫反应和组织重塑（所有这些都是导致肿瘤进展和转移的关键过程）而具有潜在的抗癌作用。
评估氨甲环酸在体外、动物和临床研究中的抗癌作用，以评估其作为重新利用的癌症药物的潜力。
该研究设计为符合PRISMA标准的系统评价和荟萃分析。在MEDLINE、EMBASE、科学网和考克兰图书馆进行文献检索。纳入了研究氨甲环酸或ε - 氨基己酸（EACA）抗癌作用的体外、动物和临床研究。对动物和临床研究进行了严格评估，偏倚风险低的研究纳入荟萃分析。
在4367条识别记录中，纳入了38篇文章，共同报告了41项体外研究、34项动物研究（n = 843只动物）和7项临床研究（n = 91例患者）的结果。荟萃分析纳入了9项动物研究，结果显示与对照组相比，接受氨甲环酸治疗的动物肿瘤生长减少，标准化平均差为 - 1.0（95%CI - 1.5； - 0.4）（p = 0.0002）。同样，大多数体外研究报告称，暴露于氨甲环酸的肿瘤细胞系增殖、活力和侵袭性降低。临床研究极易受到偏倚影响，因此无法得出任何结论。
氨甲环酸作为一种重新利用的癌症药物显示出前景，在动物和体外研究中显示出肿瘤生长、活力和侵袭性总体降低。
