Drug Candidates

The ReDO project has compiled a list of more than 70 non-cancer drugs for which there is pre-clinical and clinical evidence of anti-cancer action. . This non-exhaustive list has been compiled thanks to an active surveillance of the cancer literature. These drugs come from all areas of medicine – from anti-parasitics to antibiotics to antacids. A key part of the project is summarising the data from multiple sources, including case reports and clinical trial, so that it can be made available to the research and clinical communities. We are working closely with ecancermedicalscience, the open access from the European Institute of Oncology and the OECI, on a series of papers on these drugs, starting with six candidate drugs.

Drug Original Use
Mebendazole  Anthelminthic. Used to treat infection by threadworms and other parasitic words
Cimetidine  Antacid. Used to treat stomach ulcers.
Nitroglycerin  Vasodilator. Treatment for angina.
Itraconazole  Anti-fungal. Broad spectrum anti-fungal.
Diclofenac  NSAID. Anti-inflammatory pain relief.
Clarithromycin  Antibiotic. Used in the treatment of upper respiratory tract infections.

The drugs that we have selected as most promising share a number of common characteristics, namely:

  • They are well-known drugs, with many years of widespread clinical use, rather than newer agents recently brought into clinical use for non-cancer indications. Often they are available as generics, but this is not a primary consideration
  • The toxicology profile is good, with low toxicity even with chronic dosing. Use for metronomic protocols is seen as an advantage, though no drug is ruled out if it cannot be used in such a schedule
  • There is a plausible mechanism of action. Note that a drug need not be directly cytotoxic, candidate drugs may have putative mechanisms of action that are anti-angiogenic, inhibit particular pathways or target aspects of the tumour microenvironment
  • Strong evidence – in vitro, in vivo and human data (epidemiological, published case reports, clinical trials). Human data is scored significantly more highly than in vivo or in vitro work; results in syngeneic, orthotopic mouse models have the highest weight in pre-clinical work
  • There is evidence of efficacy at physiological dosing. There are many drugs where there is pre-clinical work that shows efficacy but at doses, or by route of administration, not achievable in patients, or only achievable at doses with significant toxicity