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Updated: May 20, 2025

Evaluating the Effectiveness of Cancer Drug Sensitization In Vitro and In Vivo
Published on: February 6, 2015
Prolonged Low-Dose Administration of FDA-Approved Drugs for Non-Cancer Conditions: A Review of Potential Targets in
Olivia Chang1, Sarah Cheon1, Nina Semenova2
1Governor's School for Science and Technology, Hampton, VA 23666, USA.
Abstract:
Though not specifically designed for cancer therapy, several FDA-approved drugs such as metformin, aspirin, and simvastatin have an effect in lowering the incidence of cancer. However, there is a great discrepancy between in vitro concentrations needed to eliminate cancer cells and the plasma concentration normally tolerated within the body. At present, there is no universal explanation for this discrepancy and several mechanisms have been proposed including targeting cancer stem cells (CSCs) or cellular senescence. CSCs are cells with the ability of self-renewal and differentiation known to be resistant to chemotherapy. Senescence is a response to damage and stress, characterized by permanent cell-cycle arrest and apoptotic resistance. Although, for both situations, there are few examples where low concentrations of the FDA-approved drugs were the most effective, there is no satisfactory data to support that either CSCs or cellular senescence are the target of these drugs. In this review, we concisely summarize the most used FDA-approved drugs for non-cancer conditions as well as their potential mechanisms of action in lowering cancer incidence. In addition, we propose that prolonged low-dose administration (PLDA) of specific FDA-approved drugs can be useful for effectively preventing metastasis formation in selected patients.
Insights
Repurposed FDA-approved drugs like metformin show promise in reducing cancer incidence. Prolonged low-dose administration may prevent metastasis by overcoming concentration discrepancies, targeting cancer stem cells, or inducing cellular senescence.
Area of Science:
- Oncology
- Pharmacology
- Drug Repurposing
Background:
- FDA-approved drugs (metformin, aspirin, simvastatin) exhibit anti-cancer effects despite not being designed for therapy.
- A significant gap exists between in vitro effective drug concentrations and in vivo tolerated plasma levels for cancer cell elimination.
Purpose of the Study:
- To review FDA-approved drugs with potential anti-cancer properties.
- To explore proposed mechanisms like targeting cancer stem cells (CSCs) and cellular senescence.
- To propose prolonged low-dose administration (PLDA) for metastasis prevention.
Main Methods:
- Literature review of FDA-approved drugs with observed effects on cancer incidence.
- Analysis of proposed mechanisms for drug efficacy at low concentrations.
- Conceptual proposal for PLDA in cancer prevention.
Main Results:
- Several FDA-approved drugs demonstrate a reduction in cancer incidence.
- Existing data on CSCs and senescence as targets for these drugs is limited.
- PLDA is proposed as a strategy to effectively prevent metastasis.
Conclusions:
- Repurposed FDA-approved drugs warrant further investigation for cancer prevention and treatment.
- PLDA of specific drugs may offer a novel approach to prevent metastasis in select patients.
- Further research is needed to validate the proposed mechanisms and therapeutic strategy.
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