Cardiovascular/anti-inflammatory drugs repurposed for treating or preventing cancer - A systematic review and meta-analysis of randomized trials

Sep 21, 2026

Uploaded by Finn

Growing interest exists in cardiovascular and anti-inflammatory medications as lower-cost options for cancer care, driven by pre-clinical signals and observational findings. This systematic review evaluated repurposed drug classes including statins, cyclo-oxygenase inhibitors, aspirin, metformin, ACE inhibitors and ARBs, and included NSAIDs due to prostaglandin blockade. PubMed and Web of Science searches (2000–2023) identified 67 randomized trials assessing survival and response outcomes. Findings showed overall limited or no benefit, despite some subgroup improvements.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions and Relevance

Introduction

DOI: 10. 1002/cam4 .7049 RESEAR CH ARTICLE Cardiovascular/anti-inflammatory drugs repurposed for treating or preventing cancer: A systematic review and meta-analysis of randomized trials David J. Benjamin1 | Alyson Haslam2 | Vinay Prasad2 1Hoag Family Cancer Institute, Newport Beach, California, USA 2Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States Correspondence David J. Benjamin, Hoag Family Cancer Institute, 1 Hoag Drive, Building 41, Newport Beach, CA 92663, USA. [Email:](Email: david.benjamin@hoag.org)[ david.benjamin@hoag.org](Email: david.benjamin@hoag.org) Funding information Arnold Ventures Abstract Background: Due to encouraging pre-clinical data and supportive observational studies, there has been growing interest in applying cardiovascular drugs (including aspirin, angiotensin-converting enzyme [ACE] inhibitors, statins, and metformin) approved to treat diseases such as hypertension, hyperlipidemia, and diabetes mellitus to the field of oncology. Moreover, given growing costs with cancer care, these medications have offered a potentially more affordable avenue to treat or prevent recurrence of cancer. We sought to investigate the anti-cancer effects of drugs repurposed from cardiology or anti-inflammatories to treat cancer. We specifically evaluated the following drug classes: HMG-CoA reductase inhibitors (statins), cyclo-oxygenase inhibitors, aspirin, metformin, and both angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors. We also included non-steroidal anti-inflammatory drugs (NSAIDs) because they exert a similar mechanism to aspirin by blocking prostaglandins and reducing inflammation that is thought to promote the development of cancer. Methods: We performed a systematic literature review using PubMed and Web of Science with search terms including “aspirin,”“NSAID,”“statin”(including specific statin drug names),“metformin,”“ACE inhibitors,” and “ARBs”(including specific anti-hypertensive drug names) in combination with “cancer.”Searches were limited to human studies published between 2000 and 2023. Main Outcomes and Measures: The number and percentage of studies reported positive results and pooled estimates of overall survival, progression-free survival, response, and disease-free survival. Results: We reviewed 3094 titles and included 67 randomized clinical trials. The most common drugs that were tested were metformin (n = 21; 30.9%), celecoxib (n = 20; 29.4%), and simvastatin (n = 8; 11.8%) . There was only one study that tested cardiac glycosides and none that studied ACE inhibitors. The most common tumor types were non-small-cell lung cancer (n = 19; 27.9%); breast (n = 8; 20.6%), colorectal (n = 7; 10.3%), and hepatocellular (n = 6; 8.8%) . Most studies This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. were conducted in a phase II trial (n = 38; 55.9%) . Most studies were tested in metastatic cancers (n = 49; 72.1%) and in the first-line setting (n = 36; 521.9%) . Four studies (5.9%) were stopped early because of difficulty with accrual. The majority of studies did not demonstrate an improvement in either progression-free survival (86.1% of studies testing progression-free survival) or in overall survival (94.3% of studies testing overall survival) . Progression-free survival was improved in five studies (7.4%), and overall survival was improved in three studies (4.4%) . Overall survival was significantly worse in two studies (3.8% of studies testing overall survival), and progression-free survival was worse in one study (2.8% of studies testing progression-free survival) . Conclusions and Relevance: Despite promising pre-clinical and populationbased data, c

FAQs

Which repurposed drug classes were evaluated in the systematic review?

The review specifically evaluated statins, cyclo-oxygenase inhibitors, aspirin, metformin, ARBs and ACE inhibitors, and also included NSAIDs due to their anti-inflammatory mechanism related to prostaglandin blockade.

How many randomized clinical trials were included, and what outcomes were assessed?

The authors included 67 randomized clinical trials selected from 3094 titles. Outcomes included overall survival, progression-free survival, response, and disease-free survival, summarized using pooled estimates and counts of positive results.

Did repurposed cardiovascular and anti-inflammatory drugs improve cancer outcomes overall?

Overall, most studies did not demonstrate improvement in progression-free survival or overall survival. Only a small fraction of trials showed improved progression-free survival or overall survival, and some studies reported worse outcomes.

Sep 21, 2026

Uploaded by Finn