The need for a rapid response to the COVID-19 pandemic has highlighted repurposing of medicines as a source of new treatments for diseases. Repurposing of medicines refers to a strategy of drug development where approved or investigational drugs are examined for uses beyond the diseases for which they were originally intended. The fundamental benefits of this approach are the reduction in time and cost of drug development, but there is still the requirement for demonstration of effectiveness and safety in the new disease context. The low efficiency and high expense of conventional oncology drug development for novel anti-cancer drugs, together with the complex intra- and inter-tumour heterogeneity necessitates examination of alternative pathways to new treatments and more effective combination therapies for cancer, particularly rare cancers.
In this presentation, efforts to repurpose medicines for the management of cancer will be reviewed (eg. thalidomide for multiple myeloma, and metformin for breast cancer). Particular attention will be focussed on the need for clinical trials, the necessity for rigor in the dissemination of information about potential treatments, and the role of efficient and safe regulatory pathways when considering long term, short term and palliative treatment contexts, issues highlighted by the COVID-19 pandemic. Innovative and adaptable clinical trial designs, such as the Molecular Screening and Therapeutics (MoST) Program, are needed to expedite translation of preclinical discoveries into improvements for patients. Alternative business models for funding the necessary clinical trials are also being considered.
Economic pressures of high cost, novel, anti-cancer drugs will only increase as our population ages. Drug repurposing offers a complementary, more rapid and more affordable approach. The COVID-19 pandemic has highlighted the need for an examination of our drug development, regulatory, and financing processes, and will stimulate increased focus on community and patient benefit-driven drug development, including for cancer patients.