Drug Repurposing in Oncology: A Systematic Review of Randomized Controlled Clinical Trials

Cancers (Basel). 2023 May 30;15(11):2972. doi: 10.3390/cancers15112972.

Abstract

Quality pharmacological treatment can improve survival in many types of cancer. Drug repurposing offers advantages in comparison with traditional drug development procedures, reducing time and risk. This systematic review identified the most recent randomized controlled clinical trials that focus on drug repurposing in oncology. We found that only a few clinical trials were placebo-controlled or standard-of-care-alone-controlled. Metformin has been studied for potential use in various types of cancer, including prostate, lung, and pancreatic cancer. Other studies assessed the possible use of the antiparasitic agent mebendazole in colorectal cancer and of propranolol in multiple myeloma or, when combined with etodolac, in breast cancer. We were able to identify trials that study the potential use of known antineoplastics in other non-oncological conditions, such as imatinib for severe coronavirus disease in 2019 or a study protocol aiming to assess the possible repurposing of leuprolide for Alzheimer's disease. Major limitations of these clinical trials were the small sample size, the high clinical heterogeneity of the participants regarding the stage of the neoplastic disease, and the lack of accounting for multimorbidity and other baseline clinical characteristics. Drug repurposing possibilities in oncology must be carefully examined with well-designed trials, considering factors that could influence prognosis.

Keywords: antineoplastic agents; drug repositioning; etodolac; imatinib; leuprolide; mebendazole; medical oncology; metformin; multimorbidity; propranolol.

Publication types

  • Review

Grants and funding

This research was funded by the Carlos III Institute of Health, Ministry of Science and Innovation (Spain), through the Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) awarded on the call for the creation of Health Outcomes-Oriented Cooperative Research Networks (grant number RD21/0016/0019), and by Gobierno de Aragón (grant number B01_20R) and co-funded with European Union’s NextGenerationEU funds.