A proposal by researchers from RISE-Health and FMUP will make it possible to “reduce the time, cost and risk associated with the development of new therapies”.
Cardiovascular medicines, specifically those that alter the contractile force of the heart muscle, alongside drugs used in the management of asthma, may offer a ‘new solution’ for the treatment of bladder cancer. This conclusion comes from a study by the RISE Health Research Unit and the Faculty of Medicine of the University of Porto (FMUP), which sought to investigate the potential repurposing of drugs associated with conditions such as heart failure and asthma for the treatment of this type of cancer.
The results, obtained in laboratory trials using bladder cancer cells, are still at an early stage and some way off clinical application. However, “we found that these drugs – milrinone and terbutaline – significantly enhanced the anti-cancer effects of 5-FU, a chemotherapy drug, in bladder cancer cells […], which indicates a specific benefit for this type of tumour”, according to the scientific paper published in the journal Cancers.
According to the study led by Nuno Vale and Eduarda Ribeiro, researchers at RISE-Health and FMUP, “terbutaline modulated the oxidative stress induced by 5-FU in bladder cancer cells. This finding is particularly interesting because oxidative stress influences the cellular response to chemotherapy and may be involved in mechanisms of tumour adaptation and resistance”.
According to the experts, the repurposing of drugs makes it possible to “reduce the time, cost and risk associated with the development of new therapies”, explaining that milrinone and terbutaline, when combined with 5-FU, reduced the cells’ ability to migrate and form new colonies – two behaviours associated with tumour progression and persistence.
Nuno Vale and Eduarda Ribeiro add that “the future aim will not, therefore, be to administer these combinations indiscriminately to all patients with bladder cancer”, emphasising that “a truly personalised strategy must also incorporate clinical, molecular and functional information for each patient.
In addition to genetic and proteomic analysis of the tumour, organoids or cell cultures derived from the patient themselves could be used to test, in the laboratory, the response to different combinations before a treatment decision is made”.
“The potential of this research lies not only in the identification of two drugs that may enhance the effect of 5-FU. It also lies in the possibility of developing an approach in which treatment is selected based on the specific characteristics of each patient’s tumour, with a view to maximising efficacy and reducing unnecessary treatments, toxicity and the risk of resistance”, the researchers conclude.