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Humble anti-fungal pill appears to have a noble side-effect: treating skin cancer

anti-fungal pill

Curing cancer isn't cheap; developing new drugs comes with a multimillion-dollar price tag. Plus, there's the rigmarole of animal testing, IRB reviews, FDA approval, and so on. What if you could just skip all of that, and get the drug to patients directly and at a lower price than an existing treatment option? You could, if you can successfully recycle a drug that's already on the shelves at the pharmacy.

A few years ago, Stanford researchers led by Philip Beachy, PhD, got an inkling that a pink-and-blue capsule that removes unsightly toenail fungi also has a secret superpower: It might be able to treat skin cancer. The first set of clinical trials testing the effect of the oral pill, itraconazole, on skin cancer is the focus of a new study published online today.

Led by Stanford dermatologist and senior author Jean Tang, MD, PhD, the study shows proof of itraconazole's ability to reduce tumor size and spread in patients with basal cell carcinoma, the most common type of skin cancer.

"We are shortcutting the [drug development] process," says Tang, "by using a drug that's already been around for 25 years and given to tens of thousands of people."

From our press release on the study:

Itraconazole, which is prescribed for common fungal infections, kills fungal cells by blocking the production of a vital membrane component. In cancer cells, the drug appears to disable the Hedgehog signaling pathway -- a cascade of cellular events triggered by the Hedgehog protein signal that is vital to cell growth and development.

Oral drugs for basal cell carcinoma are rare. These tumors are usually treated through radiation or cut out surgically. But surgery on advanced stage tumors may not always be effective and can greatly scar and disfigure patients.

Tang tested the drug itraconazole on 29 patients with a total of 101 tumors and found that it both blocked the Hedgehog pathway and reduced tumor size at the normally-prescribed anti-fungal dosage. As I describe in the release:

Patients were given itraconazole pills twice a day for a month. Another small group was given a lower dosage of itraconazole for a longer duration (an average of 10 weeks). In the first group, the drug reduced Hedgehog pathway activity by an average of 65 percent and tumor size by 24 percent. Patients in the second group, with lower itraconazole doses, showed similar reductions in tumor size.

And the best part? This medication is several times cheaper than vismodegib, the current and only go-to oral drug for basal cell carcinoma ($20 versus vismodegib's $250 per day). It can also potentially treat tumors that are immune to vismodegib and other Hedgehog-pathway-blocking cancer drugs, says Beachy.

Ranjini Raghunath is a writing intern in the medical school's Office of Communication & Public Affairs.

Previously: New skin cancer target identified by Stanford researchers, Funding basic science leads to clinical discoveries, eventually, Studies show new drug may treat and prevent basal cell carcinoma and Common drug might help prevent skin cancers
Photo by Worak

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