Beyond infection control: exploring the therapeutic potential of antimicrobials in oncology and their synthetic...

The repurposing of FDA-approved antimicrobial agents for oncology presents a promising therapeutic strategy to accelerate drug development and enhance clinical outcomes in cancer therapy. This strategy has gained significant interest because it is faster, more cost-effective, and involves fewer safety uncertainties than the traditional process for developing new molecular entities. Several established therapeutic agents, including minoxidil, raloxifene, propranolol, aspirin, chloroquine, and metformin, have been successfully repurposed to explore additional pharmacological applications. In cancer therapy, patients often have compromised immune systems, making them highly vulnerable to bacterial infections. Although antimicrobials do not directly boost immunity, they play a crucial role in preventing infections and, in some instances, exert direct anticancer effects by disrupting cellular pathways critical for tumor proliferation. Beyond their primary antimicrobial functions, several antibiotics, antivirals, antifungals, and anthelmintics show intrinsic anticancer activities through DNA intercalation, topoisomerase inhibition, mitochondrial dysfunction, reactive oxygen species (ROS) generation, and immunomodulation. These agents also exert antitumor effects by modulating key oncogenic pathways, such as Wnt/β-catenin, mTOR, and Hedgehog, and by selectively targeting cancer stem cells as well as tumor-associated microbiota. This review aims to explore the burgeoning potential of antimicrobial agents in oncology, highlighting their roles in reducing infection-related mortality, enhancing therapeutic effectiveness, and improving the overall quality of life in cancer patients.