Repurposing everyday drugs to fight cancer

[AussieNeil]

'Pan Pantziarka is a London-based computer scientist for the Anticancer Fund in Belgium, and joint coordinator of the Repurposing Drugs in Oncology (ReDo) project. He is chairman of the George Pantziarka TP53 Trust.' Linda Geddes interviews him for New Scientist (free registration may be required) : newscientist.com/article/mg...

Some excerpts of article I help repurpose everyday drugs like aspirin to fight cancer.

Specialist drugs are getting outwitted by cancer. Pan Pantziarka says a solution may be right under our noses

What are the main challenges you face getting repurposed drugs approved to treat cancer?

The patents have expired on the majority of the drugs, so any drug company that invests in a clinical trial is not guaranteed to recoup that money because some other manufacturer could swoop in and sell the same drug at a lower price. Also, if the trial is successful, getting the drug licensed costs money.

Secondly, very few of these drugs are going to be effective on their own: we are looking at using them in combination with standard therapies or other repurposed drugs. In that situation multiple companies are involved, which raises issues around cooperation.

If you are doing a trial without a pharmaceutical company, there are logistical issues: you have to buy the drugs yourself and even cheap drugs aren’t that cheap. You also have to package up the placebo and the drug – so you have highly paid consultants shoving aspirin into unmarked containers.

What solutions are you coming up with?

We supported a UK crowdfunding project to repurpose a malaria drug called artesunate as a colorectal cancer drug. The response was great and we exceeded the target of £50,000. But it’s not a sustainable model because it takes a huge amount of work, and while the public wants to be involved, compassion fatigue will kick in as the number of appeals grows. That’s particularly true for rare cancers, as there’s not a huge constituency of patients we can mobilise. So we have to look at other options.

Some might accuse you of encouraging cancer patients to turn away from conventional therapies that could save their lives.

All cancer patients and their families have the right to seek alternative opinions. But I work for a foundation called the Anticancer Fund, which funds some research into repurposed drugs, and we spend a lot of time exposing fake cancer cures. We don’t recommend that people stop their current treatment; for any faults it may have, it’s better than no treatment. Instead we supply information for people to take to their oncologist and discuss with them. We don’t encourage people to self-medicate, although we know some people do. When it’s someone’s life at stake, people do extraordinary things – and for good reason.

Neil

Photo: Bee visiting a Geraldon Wax flower.

[cllady01 Former Volunteer]

Neil, interesting read for me who contemplates the no treatment route when the option comes.

This statement: "We don’t recommend that people stop their current treatment; for any faults it may have, it’s better than no treatment."

is one that puzzles me. Has there been statistics to back up that kind of statement? Has there been any documented cases of "just" palliative care with no side effects for B symptoms as they arise? (I am assuming palliative care is not "treatment" in the sense meant here.

And, my question is not about stopping a current "treatment"--it is about never beginning a "treatment," which I assume is pointing to the nibs, mubs, etc.

[AussieNeil Partner Administrator in reply to cllady01]

The "We don’t recommend that people stop their current treatment" answer was given in the context of cancer patients seeking alternatives to their current treatment. (The interviewer had just stated "Some might accuse you of encouraging cancer patients to turn away from conventional therapies that could save their lives.") Conventional cancer treatments, having been determined via evidence based clinical trials, should be providing the best treatment option available to a patient - providing the specialist who recommended the treatment has been keeping up to date with new developments. So yes, the statistics to back up that statement would be included in the analysis of patients undergoing a clinical trial that proved the treatment being provided was better than an older/alternative treatment.

With regard to palliative care and not starting any treatment to reduce the clonal B-cell burden for someone with CLL, the palliative care would very much depend on how the CLL was threatening the life of the person concerned. In the case of bone marrow failure, it would involve propping up the patient with transfusions, presumably until the patient died from an infection. Transfusions can replace red blood cells and platelets, but not neutrophils, which can't be transplanted due to their short life. Forcing the bone marrow with G-CSF injections won't work when the bone marrow is fully infiltrated with CLL cells. If the patient had anaemia and red blood cell transfusions were not given, the CLL patient would die of organ failure due to lack of blood oxygenation. If the patient had low platelets (thrombocytopenia), and not provided with platelet transfusions, then death would eventually be due to uncontrolled internal bleeding. As to documentation - just go through death certificates and look at patient records for CLL patients from a few decades ago...

Not sure what you mean by 'nibs, mubs, etc'

Neil

[cllady01 Former Volunteer in reply to AussieNeil]

Ah, thank you for your reply, it is good to have some info relative to symptoms and their likely path without treatment.

Reality is difficult to come by second handedly--but it does help to have some clues.

I meant all the chemo/bios treatment name endings. Too lazy to look up the full names.