A study published this week suggests nitroglycerin – which is technically a drug despite being more usually thought of as the key ingredient in Alfred Nobel’s explosive – can be used to address the tumour hypoxia responsible for many cancer treatment failures.
The idea is that nitroglycerin will be used to oxygenate tumours, which in turn will allow chemotherapies to function more effectively as lead research Pan Pantziarka explained.
“Nitroglycerin shows promise as a drug to reduce tumour-associated hypoxia and to improve delivery of therapeutic agents to solid tumours. It is envisaged that transdermal nitroglycerin patches are used to deliver the drug at the same time as existing chemo and chemo-radiotherapy treatments.
Dr Pantziarka told us “evidence from in vivo studies and a number of small clinical trials that nitroglycerin can improve oxygenation and reduce the hypoxic fraction of solid tumours. This has been assessed using appropriate biomarkers and imaging.
Hypoxia is a major challenge in oncology. It is well established that a lack of oxygen within tumours makes them resistant to treatment by radio- and chemotherapies.
The team are examining nitroglycerin combined with existing therapies in non-small cell lung cancer in a study as part of the Repurposing Drugs in Oncology (ReDO) project, which is a collaboration between the Anticancer Fund, Belgium and US-based group GlobalCures.
Pantziarka told us: “We expect that as proof of efficacy is shown in these trials the use of nitroglycerin will expand. There is also a potential for nitroglycerin to improve delivery of drugs, including a number of repurposed drugs, to tumours.
He added that: “The choice of drugs to combine with nitroglycerin will most likely be based on the degree of evidence that those drugs will show additional clinical benefit by improved diffusion into tumour masses.”
“Repurposing Drugs in Oncology (ReDO)—nitroglycerin as an anti-cancer agent”
Authors: Vidula Sukhatme, Gauthier Bouche, Lydie Meheus, Vikas P Sukhatme and Pan Pantziarka