Repurposing calcium channel blockers: may be sensible combination with erlotinib for non-small cell lung cancer
Celal Alandağ1, Elif Merev1, Feyyaz Özdemir1
1Department of Medical Oncology, Sivas Numune Hospital, Sivas.
Abstract:
Erlotinib is a tyrosine kinase inhibitor that inhibits epidermal growth factor receptor. It is being used for metastatic non-small cell lung cancer patients (NSCLC). Repurposing noncancer drugs for cancer treatment is a current issue and it has many advantages. We planned to reveal the effects of noncancer drugs [calcium channel blockers (CCBs) and others] on erlotinib. We scanned the files of NSCLC patients retrospectively who were applied to Karadeniz Technical University between January 2013 and April 2019 and used erlotinib. There were 63 patients, 9 of them were taking CCB simultaneously for arterial hypertension. We analyzed some parameters of these patients and their effects on overall survival (OS) and progression-free survival (PFS). A χ2 or Fisher's exact test, Kaplan-Meier and Cox regressions were used in the statistical analysis. 12-month OS rates of CCB user and nonuser were 78.3 and 39.7%, respectively, [odds ratio (OR),0.14; 95% confidence interval (CI), 0.27-0.75; P = 0.023]. 24-month PFS rates of CCB user and nonuser were 44.4 and 8.3%, respectively (OR,0.11; 95% CI, 0.02-0.60; P = 0.016). There was 12-month OS and 24-month PFS advantage with simultaneously taking CCBs and erlotinib, they have an additive effect for NSCLC. This study will be inspiring future prospective studies.
Insights
Calcium channel blockers (CCBs) combined with erlotinib show improved survival rates for non-small cell lung cancer (NSCLC) patients. This drug repurposing strategy offers a potential additive effect, enhancing treatment outcomes for NSCLC.
Area of Science:
- Oncology
- Pharmacology
- Medical Research
Background:
- Erlotinib, an EGFR tyrosine kinase inhibitor, treats metastatic non-small cell lung cancer (NSCLC).
- Drug repurposing of non-cancer medications for cancer treatment is an emerging area with significant potential.
- Investigating the impact of co-administered non-cancer drugs on erlotinib efficacy is crucial for optimizing NSCLC therapy.
Purpose of the Study:
- To evaluate the effect of calcium channel blockers (CCBs) on the efficacy of erlotinib in NSCLC patients.
- To determine if CCBs have an additive or synergistic effect when used concurrently with erlotinib.
- To analyze the impact of CCB co-administration on overall survival (OS) and progression-free survival (PFS) in NSCLC patients treated with erlotinib.
Main Methods:
- Retrospective analysis of 63 NSCLC patients treated with erlotinib at Karadeniz Technical University (January 2013 - April 2019).
- Comparison of OS and PFS between patients taking CCBs concurrently with erlotinib (n=9) and those not taking CCBs (n=54).
- Statistical analysis included Chi-squared or Fisher's exact test, Kaplan-Meier, and Cox regression models.
Main Results:
- Patients using CCBs concurrently with erlotinib demonstrated significantly higher 12-month OS rates (78.3% vs. 39.7%, P=0.023).
- CCB users also showed improved 24-month PFS rates (44.4% vs. 8.3%, P=0.016) compared to non-users.
- An odds ratio of 0.14 for OS and 0.11 for PFS indicated a significant survival advantage with CCB co-administration.
Conclusions:
- Concurrent use of calcium channel blockers (CCBs) with erlotinib is associated with a significant survival advantage in NSCLC patients.
- CCBs may exert an additive effect with erlotinib, enhancing treatment outcomes in NSCLC.
- These findings support further investigation in prospective clinical trials to confirm the benefits of CCB and erlotinib combination therapy.
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