The Neurokinin-1 Receptor Antagonist Aprepitant: An Intelligent Bullet against Cancer?

Area of Science:

• Oncology
• Pharmacology

Background:

• Neurokinin-1 receptor (NK-1R) antagonists exhibit antitumor properties, including antiproliferative, anti-Warburg, apoptotic, anti-angiogenic, and antimetastatic effects across diverse cancer types.
• Aprepitant, an NK-1R antagonist approved for antiemetic use, has demonstrated these antitumor actions in preclinical studies.
• The substance P (SP)/NK-1R system's potential link to cancer and depression warrants further investigation.

Purpose of the Study:

• To review the multifaceted antitumor actions of aprepitant.
• To explore the potential of repurposing aprepitant as a novel anticancer therapeutic agent.

Main Methods:

• Review of in vivo and in vitro studies on NK-1R antagonists and aprepitant's anticancer effects.
• Analysis of clinical data, including a case of successful combination therapy with aprepitant and radiotherapy for lung carcinoma.

Main Results:

• Aprepitant exhibits broad-spectrum antitumor activities, including antiproliferative and anti-angiogenic effects.
• A case report demonstrated successful tumor mass reduction and absence of side-effects using aprepitant combined with radiotherapy.
• Preclinical data support aprepitant's potential in preventing cancer recurrence and metastasis.

Conclusions:

• Aprepitant demonstrates significant potential as an anticancer agent due to its diverse antitumor mechanisms.
• Repurposing aprepitant for cancer treatment is supported by existing evidence, suggesting its use in clinical practice.
• Further research into the SP/NK-1R pathway may elucidate links between cancer and depression, offering new therapeutic avenues.