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Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study
BACKGROUND: Only 5% of the molecules tested in oncology phase 1 trials reach the market after an average of 7.5 years of waiting and at a cost of tens of millions of dollars. To reduce the cost and shorten the time of discovery of new treatments, “drug repurposing” (research with molecules already a...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686206/ https://www.ncbi.nlm.nih.gov/pubmed/37962929 http://dx.doi.org/10.2196/48925 |
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author | Rodríguez-Molinero, Alejandro Pérez-López, Carlos Salazar González, Jose L Garcia-Lerma, Esther Álvarez-García, Juan A Soria Morillo, Luis M Salas Fernández, Tomás |
author_facet | Rodríguez-Molinero, Alejandro Pérez-López, Carlos Salazar González, Jose L Garcia-Lerma, Esther Álvarez-García, Juan A Soria Morillo, Luis M Salas Fernández, Tomás |
author_sort | Rodríguez-Molinero, Alejandro |
collection | PubMed |
description | BACKGROUND: Only 5% of the molecules tested in oncology phase 1 trials reach the market after an average of 7.5 years of waiting and at a cost of tens of millions of dollars. To reduce the cost and shorten the time of discovery of new treatments, “drug repurposing” (research with molecules already approved for another indication) and the use of secondary data (not collected for the purpose of research) have been proposed. Due to advances in informatics in clinical care, secondary data can, in some cases, be of equal quality to primary data generated through prospective studies. OBJECTIVE: The objective of this study is to identify drugs currently marketed for other indications that may have an effect on the prognosis of patients with cancer. METHODS: We plan to monitor a cohort of patients with high-lethality cancers treated in the public health system of Catalonia between 2006 and 2012, retrospectively, for survival for 5 years after diagnosis or until death. A control cohort, comprising people without cancer, will also be retrospectively monitored for 5 years. The following study variables will be extracted from different population databases: type of cancer (patients with cancer cohort), date and cause of death, pharmacological treatment, sex, age, and place of residence. During the first stage of statistical analysis of the patients with cancer cohort, the drugs consumed by the long-term survivors (alive at 5 years) will be compared with those consumed by nonsurvivors. In the second stage, the survival associated with the consumption of each relevant drug will be analyzed. For the analyses, groups will be matched for potentially confounding variables, and multivariate analyses will be performed to adjust for residual confounding variables if necessary. The control cohort will be used to verify whether the associations found are exclusive to patients with cancer or whether they also occur in patients without cancer. RESULTS: We anticipate discovering multiple significant associations between commonly used drugs and the survival outcomes of patients with cancer. We expect to publish the initial results in the first half of 2024. CONCLUSIONS: This retrospective study may identify several commonly used drugs as candidates for repurposing in the treatment of various cancers. All analyses are considered exploratory; therefore, the results will have to be confirmed in subsequent clinical trials. However, the results of this study may accelerate drug discovery in oncology. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48925 |
format | Online Article Text |
id | pubmed-10686206 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-106862062023-11-30 Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study Rodríguez-Molinero, Alejandro Pérez-López, Carlos Salazar González, Jose L Garcia-Lerma, Esther Álvarez-García, Juan A Soria Morillo, Luis M Salas Fernández, Tomás JMIR Res Protoc Protocol BACKGROUND: Only 5% of the molecules tested in oncology phase 1 trials reach the market after an average of 7.5 years of waiting and at a cost of tens of millions of dollars. To reduce the cost and shorten the time of discovery of new treatments, “drug repurposing” (research with molecules already approved for another indication) and the use of secondary data (not collected for the purpose of research) have been proposed. Due to advances in informatics in clinical care, secondary data can, in some cases, be of equal quality to primary data generated through prospective studies. OBJECTIVE: The objective of this study is to identify drugs currently marketed for other indications that may have an effect on the prognosis of patients with cancer. METHODS: We plan to monitor a cohort of patients with high-lethality cancers treated in the public health system of Catalonia between 2006 and 2012, retrospectively, for survival for 5 years after diagnosis or until death. A control cohort, comprising people without cancer, will also be retrospectively monitored for 5 years. The following study variables will be extracted from different population databases: type of cancer (patients with cancer cohort), date and cause of death, pharmacological treatment, sex, age, and place of residence. During the first stage of statistical analysis of the patients with cancer cohort, the drugs consumed by the long-term survivors (alive at 5 years) will be compared with those consumed by nonsurvivors. In the second stage, the survival associated with the consumption of each relevant drug will be analyzed. For the analyses, groups will be matched for potentially confounding variables, and multivariate analyses will be performed to adjust for residual confounding variables if necessary. The control cohort will be used to verify whether the associations found are exclusive to patients with cancer or whether they also occur in patients without cancer. RESULTS: We anticipate discovering multiple significant associations between commonly used drugs and the survival outcomes of patients with cancer. We expect to publish the initial results in the first half of 2024. CONCLUSIONS: This retrospective study may identify several commonly used drugs as candidates for repurposing in the treatment of various cancers. All analyses are considered exploratory; therefore, the results will have to be confirmed in subsequent clinical trials. However, the results of this study may accelerate drug discovery in oncology. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48925 JMIR Publications 2023-11-14 /pmc/articles/PMC10686206/ /pubmed/37962929 http://dx.doi.org/10.2196/48925 Text en ©Alejandro Rodríguez-Molinero, Carlos Pérez-López, Jose L Salazar González, Esther Garcia-Lerma, Juan A Álvarez-García, Luis M Soria Morillo, Tomás Salas Fernández. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 14.11.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included. |
spellingShingle | Protocol Rodríguez-Molinero, Alejandro Pérez-López, Carlos Salazar González, Jose L Garcia-Lerma, Esther Álvarez-García, Juan A Soria Morillo, Luis M Salas Fernández, Tomás Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study |
title | Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study |
title_full | Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study |
title_fullStr | Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study |
title_full_unstemmed | Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study |
title_short | Drug Repurposing for Cancers With Limited Survival: Protocol for a Retrospective Cohort Study |
title_sort | drug repurposing for cancers with limited survival: protocol for a retrospective cohort study |
topic | Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686206/ https://www.ncbi.nlm.nih.gov/pubmed/37962929 http://dx.doi.org/10.2196/48925 |
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