Antifungal drug eliminates sleeping bowel cancer cells in mice

In continuation of my update on  itraconazole 

An antifungal medication, commonly prescribed for toenail infections, could help eliminate dormant cells within bowel tumours, according to new research funded by Cancer Research UK and published in the Journal of Experimental Medicinetoday.

Researchers at the Cancer Research UK Cambridge Institute have shown in laboratory studies in mice, that itraconazole effectively halts the growth and progression of certain types of bowel cancer. The next step will be to see if this holds true in patients with the disease.

Dr. Simon Buczacki, co-lead author and Cancer Research UK clinician scientist, said: "One of the biggest challenges in treating any cancer is the diversity of different cells within the same tumour. We've targeted a type of cell that lies asleep within bowel tumours, remaining unresponsive to treatment and putting the patient at risk of their cancer coming back."

The Cambridge team characterised the molecular nature of dormant bowel cancer cells. These 'sleeping' cells are resistant to drugs, including chemotherapy, which work by targeting cells that are actively growing. So even if it looks like a treatment has worked, some of these dormant cells can later awaken after treatment has finished and lead to the tumour re-growing.

The scientists identified two key pathways involved in cell dormancy and used miniature bowel tumours grown from the cells of mice with cancer, to test different drugs targeting these pathways.

They found, for the first time, that itraconazole blocked signals from a pathway called Wnt, which is implicated in the growth and spread of many different cancers. This led to the tumours collapsing in the mice—dormant cells disappeared and the tumour stopped growing.

"What's interesting is that this drug seems to kick both dormant and non-dormant cells into action," added Dr. Simon Buczacki. "It forces cells back into a short cycle of growth before slamming on an irreversible 'stop' button, entering a permanent standstill that's known as senescence."

The next stage will be to test this drug in people. The researchers hope to set up a clinical trial where they can test its effect on patients with hard to treat advanced bowel cancer. They also intend to investigate whether this drug could be more effective in combination with other treatments like chemotherapy.

Professor Greg Hannon, director of the Cancer Research UK Cambridge Institute, said: "This innovative study has taken a step toward addressing one of the biggest challenges in cancer research. Tumours are made up of many different types of cancer cells, which can evolve separately and respond to treatments differently.

"The presence of drug-resistant, dormant tumour cells is a problem in many types of cancer. If we find ways to target these cells in bowel cancer, it might provide insights into tackling the problem of dormant tumour cells more broadly."

Ref : http://jem.rupress.org/content/early/2018/05/30/jem.20171385

Itraconazole drug shows potential in cancer treatment

In continuation of my update on Itraconazole

Anti-fungal drug shows promise as potential new cancer treatment.A common anti-fungal treatment has joined the ranks of drugs that may be suitable for use in treating cancer, according to research from the Repurposing Drugs in Oncology (ReDO) project published in ecancermedicalscience.  

The ReDO project is an international collaboration of anticancer researchers dedicated to promoting the cause of common medicines which may represent an untapped source of novel therapies for cancer.

In partnership with ecancer, the ReDO project is publishing a series of papers on drugs that have enough clinical evidence to be taken to clinical trials.Itraconazole is a drug used to treat a broad range of fungal infections, including skin and nail infections.

It also has a lot of potential as a new cancer treatment, according to the ReDo project.

"Itraconazole shows potential in a number of areas with high unmet patient needs, particularly in non-small cell lung cancer and possibly in some rarer malignancies," says Pan Pantziarka, PhD, member of the ReDO project and the Anticancer Fund.

Itraconazole drug shows potential in cancer treatment

Nearly five million asthmatics worldwide could benefit from antifungal therapy

Clinical studies have shown that oral antifungal drugs significantly improve symptoms and asthma control in asthmatics with ABPA, treatment endorsed by the Cochrane Collaboration. This is the first time that a global estimate of ABPA numbers has been made.

In national league tables of asthma rates in adults, only Australia and Sweden have a higher prevalence than the UK. In global league tables of ABPA occurrence, New Zealand tops the list with a 3.5% rate in new patients attending chest clinics at hospitals. The rates were 2.6% in Cape Town, 2.3% in Saudi Arabia, 2.5% in China and 0.7% in an older study from Ireland. No population-based studies have been done.

Itraconazole

Posaconazole

Voriconazole

In addition to standard asthma therapy, the antifungal therapy used is itraconazole  now a generic, inexpensive antifungal  with a response rate of 60%. The researchers also found that antifungal therapy also benefits patients with severe asthma sensitized to fungi, called SAFS.

Alternatives include voriconazole and posaconazole, which have 75-80% response rates. In a recent assessment of voriconazole and posaconazole for both ABPA and SAFS, 75% of patients were able to stop taking oral corticosteroids, a major benefit, and 38% of patients had their asthma severity downgraded on antifungal therapy.

Professor David Denning, professor of medicine and medical mycology at the University of Manchester and Director of the University Hospital of South Manchester's National Aspergillosis Centre, led the study into the total number of asthmatics worldwide. He said the study results implied that asthma admissions and deaths could be avoided with more extensive use of antifungal therapy.

"We were surprised by the number of patients with ABPA, and by the lack of community based studies done," he said. "Our National Aspergillosis Centre treats hundreds of these patients each year, generally with major improvement, and so a conscious program to seek out ABPA from all asthmatics is required."

Professor Donald Cole of the Dalla Lana School of Public Health at the University of Toronto was the senior author of the study and contributed his expert epidemiological knowledge to the development of the model and provided a 'reality' check of the model's estimates.

Nearly five million asthmatics worldwide could benefit from antifungal therapy