how a diabetes drug is making chemotherapy more effective against lung cancer
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lung cancer can evade chemotherapy drugs because of a process known as lineage plasticity, which is the ability to change or adopt new characteristics or states that are no longer targeted by the chemotherapy medication.
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the latest research out of the university of missouri school of medicine has found an interesting new way to improve the efficacy of chemotherapy in people with drug-resistant lung cancer.
the study, which looked at the use of the diabetic neuropathy drug epalrestat, found that when introduced into the treatment plans of those undergoing lung cancer treatment, it helped the cells be more susceptible to the effects of chemotherapy.
these findings suggest an easier way to improve the overall success of cancer treatment in people with lung cancer.
drug-resistant lung cancer
in many cases, people with lung cancer develop a type of drug resistance to chemotherapy. when this happens, cancer cells are no longer targeted as they should be and are left to multiply freely and grow in numbers.
drug resistance can also lead to cancer recurrence because the therapy is unable to rid the body of all cancer cells, allowing them to pick up where they started before the treatment was done.
roughly half of all non-metastatic, non-small lung cancers recur in patients, causing a higher rate of mortality.
lung cancer can evade chemotherapy drugs because of a process known as lineage plasticity, which is the ability to change or adopt new characteristics or states that are no longer targeted by the chemotherapy medication. when the drugs can’t target the right cells, the cancer is left to its own devices.
epalrestat and lung cancer
epalrestat is a form of aldose reductase inhibitor that prevents nerve damage in people with diabetes. it works by inhibiting the action of enzymes known as aldose reductases akr1b1 and akr1b10. these enzymes ensure that aldose, a type of simple sugar, is converted properly within the body so it can be used in various ways.
in people with lung cancer, the akr1b10 aldose reductase enzyme is overexpressed, meaning it exists in too high a number within the body. the study’s hypothesis was that if that specific enzyme is overexpressed, hindering that process may be helpful in treating the disease.
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the study results
the study, “targeting akr1b10 by drug repurposing with epalrestat overcomes chemoresistance in non-small cell lung cancer patient-derived tumour organoids”, looked at a total of 10 non-small cell lung cancer tumours. out of those 10, half were found to be resistant to traditional chemotherapy.
when the researchers introduced epalrestat into the equation, the overexpression of akr1b10 was corrected, leading to the tumours becoming more sensitive to the powers of chemotherapy drugs and, in turn, offering more effective treatment.
these promising results show another way to use epalrestat that has nothing to do with diabetes and everything to do with changing the way lung cancer patients respond to treatment. this could lead to better outcomes and lower levels of recurrence.
repurposing drugs for cancer treatment
creating new drugs to treat cancer can be a long and arduous process. from development to clinical trials, it can take years and a lot of money and grants for researchers to get new drugs off the ground and into the hands of patients.
by repurposing existing drugs that can have beneficial off-label effects, they significantly reduce the process time, making new therapies more accessible in the short term rather than the long term.
in the case of epalrestat for lung cancer, the drug, which is already approved for use in japan, china, and india, can be fast-tracked into the hands of clinicians and their patients if it becomes approved for this specific use in canada.
future directions
as of writing, epalrestat is not approved in canada. the new study results have paved the way for high-level clinical trials conducted by the food and drug administration (fda) in the united states. however, there is no current news on whether canada will follow suit in the upcoming years.
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if the fda grants approval for epalrestat for lung cancer treatment, it can be brought to people with lung cancer sooner, but the trials mentioned above are still ongoing.
using drugs off-label or repurposed is a longstanding tradition that has helped medical researchers, clinicians, and patients find new ways to treat old diseases. if all goes well with epalrestat, those living with lung cancer will have another potentially lifesaving tool to use during their treatment.
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