Perioperative Therapies-Using Repurposed Drugs to Improve Cancer Surgery Outcomes

Reducing the rate of recurrence after curative-intent surgical resection is an attractive strategy for improving long-term survival in cancer. Perioperative therapies administered in the period immediately prior to, during, or after surgery therefore hold the potential to improve overall survival. Drug repurposing is a source of therapeutic candidates for further clinical investigation. We aimed to identify noncancer drugs with the potential to be repurposed as perioperative therapies.

The Repurposing Drugs in Oncology repurposing database and PubMed were used for a literature-based search of publications related to perioperative treatment of cancer. Three clinical trials registries were also searched to identify relevant clinical trials with survival endpoints. Both the literature and trial screens were supplemented with additional data known to the authors.

Fifty-two drugs were identified as potential perioperative therapies, with 67% having supporting human data. There are few clinical trials with survival endpoints, mainly in breast and colorectal cancers.

The perioperative setting is not as well established as the neoadjuvant and adjuvant settings, making identification of relevant research and clinical trials difficult. Despite the potential benefits of such interventions, there is a need for more well-designed clinical trials, additional research, and biomarkers of response.