Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis

Area of Science:

• Oncology
• Pharmacology
• Drug Repurposing

Background:

• Drug repurposing is a viable strategy for discovering novel cancer therapeutics.
• Tranexamic acid (TXA), an antifibrinolytic agent, influences pathways critical to tumor progression, including proliferation, angiogenesis, and inflammation.

Purpose of the Study:

• To systematically evaluate the anticancer effects of Tranexamic acid (TXA).
• To assess TXA's potential as a repurposed cancer drug through in vitro, animal, and clinical studies.

Main Methods:

• A PRISMA-compliant systematic review and meta-analysis was conducted.
• Literature search across major databases (MEDLINE, EMBASE, Web of Science, Cochrane Library).
• Inclusion of in vitro, animal, and clinical studies on TXA or epsilon-aminocaproic acid (EACA); critical appraisal and meta-analysis of low-risk bias studies.

Main Results:

• 38 articles were included, encompassing 41 in vitro, 34 animal, and 7 clinical studies.
• Meta-analysis of 9 animal studies demonstrated a significant reduction in tumor growth with TXA treatment (SMD -1.0, p=0.0002).
• In vitro studies consistently showed reduced tumor cell proliferation, viability, and invasiveness upon TXA exposure; clinical studies had high bias.

Conclusions:

• Tranexamic acid (TXA) exhibits potential as a repurposed anticancer agent.
• Preclinical evidence (in vitro and animal models) indicates TXA reduces tumor growth, viability, and invasiveness.
• Further high-quality clinical trials are needed due to bias in existing human studies.