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Editorial
. 2020 Jan 31;39(1):26.
doi: 10.1186/s13046-020-1534-z.

Repurposing chlorpromazine in the treatment of glioblastoma multiforme: analysis of literature and forthcoming steps

Claudia Abbruzzese  1 , Silvia Matteoni  1 , Michele Persico  1 , Veronica Villani  2 , Marco G Paggi  3
Affiliations
Editorial

Repurposing chlorpromazine in the treatment of glioblastoma multiforme: analysis of literature and forthcoming steps

Claudia Abbruzzese et al. J Exp Clin Cancer Res. .

Abstract

Background: Glioblastoma multiforme is a CNS cancer characterized by diffuse infiltrative growth, aggressive clinical behavior and very poor prognosis. The state-of-art clinical approach to this disease consists of surgical resection followed by radiotherapy plus concurrent and adjuvant chemotherapy with temozolomide. Tumor recurrence occurs in virtually all cases, therefore, despite any treatment, the median survival is very low (14.6 months), which makes the approach to these patients a challenging clinical issue.

Main body: The escalating costs and times required for new medications to reach the bedside make repurposing or repositioning of old drugs, when scientific bases allow their use in other pathologies, an appealing strategy. Here, we analyze a number of literature data concerning the antipsychotic chlorpromazine, the founder of the phenothiazines class of drugs, a medication widely used in the clinics for approximately 60 years. The drug exerts its effects on psychiatric patients by interfering with the dopamine receptor D2, although more recent pharmacodynamics studies ascribe chlorpromazine a series of biological effects on cancer cells, all converging in hindering also glioblastoma survival capabilities.

Short conclusions: On these bases, and assisted by the information on the well-established chlorpromazine toxicity and dosage in humans, we designed a Phase II clinical trial involving the combination of chlorpromazine with the standard treatment, temozolomide, in the adjuvant phase of the therapeutic protocol. Patients displaying hypo-methylation of the MGMT gene, and thus intrinsically resistant to temozolomide, will be enrolled. The endpoints of this study are the analysis of toxicity and clinical activity, as evaluated in terms of Progression-Free Survival, of the association of chlorpromazine with the first-line treatment for this very serious form of cancer.

Keywords: Antipsychotic drugs; Brain tumors; Clinical trial; Drug repositioning; Signal transduction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Multiple effects of CPZ on GBM cells. The biological processes where CPZ exerts a detrimental role in GBM growth and survival parameters are represented. The associated references are also indicated
See this image and copyright information in PMC

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