The ReDO project, ReDO stands for Repurposing Drugs in Oncology. The idea is to promote clinical research with compounds, drugs that are used for other indications, because there are a lot of data on some of those drugs but the data are scattered. People with interest in those drugs are also scattered around the world and, as you can imagine, since most of those drugs are generic there is no financial interest by any company to develop those drugs in cancer further. So the idea is really to raise awareness on the potential of those drugs for anti-cancer treatment and to summarise the scientific evidence and then have them published and thanks to your help on the ecancer website and in ecancer medical sciences.
So you’ll be publishing a series of papers highlighting drugs that can be potentially used in cancer?
Yes, we’re going to publish a series of papers of those drugs. We made a selection; it was quite hard to make a selection because six months ago we had a list of 62 drugs that could be of potential interest. All those 62 drugs had some human data showing some efficacy, potential efficacy, for cancer so we had to make a selection. So we’ll start with a series of five drugs; all of them are generic drugs like mebendazole which is used to treat worm infections; like cimetidine which was used in the past but it’s still used to treat gastric ulcers and also nitro-glycerine which is a patch that you use to treat angina pectoris for instance.
What criteria did you use to select them?
The criteria, as I said, it’s extremely important for us to have human data. So for the drugs I’ve just mentioned it depends but we have some clinical trials data in cancer for some of them that they have shown some efficacy. We try to understand why it has not been taken by the cancer community. So there are some very small clinical trials trying to replicate the results of the previous clinical trials but we understand that we need to go bigger so we can make sure that if those drugs are effective they have to be used in the clinic.
What about economic factors?
There’s definitely an economic factor, as you know, and I’m not going to tell you that the cost of the drugs is increasing really steadily. So there’s definitely an advantage for drug repurposing because you save time, because you know your drug is safe, for instance. You know the toxicity profile so you know the contra-indication, the precautions of use already so this is all very useful to shorten the time of the development. Those drugs are usually generic drugs but not always. Then, of course, they are low cost and for the middle and low income countries that could be extremely useful, but also for the richer countries.
Are drug companies resistant to this drug repurposing?
Actually resistance might be a big word because they’re not really doing it but they’re not refractory to it but they’re not really helping. Like when you ask for some financial support for the trial they’re not going to give it because they have, of course, no financial interest. Usually those drugs are off patent so there won’t be any return on the investment possible. There are some possibilities sometimes if you have a patent; it’s called method of use or use patent where you say, “OK, my patent is about the use of that drug in cancer,” and sometimes then it will be granted the patent and some companies can then try to develop it further. But this is really the exception; most of the time there is no patent, it’s impossible so then the company are not going to support any research with the compound.
What about metronomic therapy?
Metronomic therapy is the idea that you give a frequent dose of the treatment daily and this is opposed to the usual way to administer anti-cancer drugs, especially chemotherapy, where you give maximum tolerated dose every three weeks. But then here the metronomic term was coined first for chemotherapy where you give a lower dose every day for a longer period of time. But for drug repurposing in a way that could also be coined, metronomic, because the idea that you give a dose of those treatments every day for a longer period of time and you hope and expect that that way of administering the treatment is going to give a better outcome in the end.
Can you tell us about the re-launch of the ReDO project?
The ReDO project is going to be officially launched on 10th July because the papers will be published that day. The two papers, there’s a policy paper explaining all the problems, all the issues and all the future prospectives for drug repurposing and, at the same time, the same day will be published the first paper on one specific drug, which is mebendazole. At the same time both organisations, the Anticancer Fund and Global Cures, which is also a non-profit organisation from the US, we will do press releases in our respective countries just to raise awareness on that issue and hope that we will reach clinicians, the public and possibly other stakeholders to show that there is a huge interest in trying to repurpose those drugs for cancer.