Antabuse (disulfiram) as an affordable and promising anticancer drug

Abstract

Recently, Cvek proposed that special clinical trials be funded by government or charities for “old” drugs like antabuse (disulfiram).1 We are raising both hands in support of his idea. Believe it or not, a novel mechanism of disulfiram on prostate cancer growth inhibition was recently published.2 Noting this, we think that serious action is needed to move these findings forward. In the mid of financial crisis, spending thousands of dollars to buy brand new drugs to extend only a few weeks of “precious” life is a hard decision to make. The fact is, a plethora of old drugs maybe better than the newcomers for a specific indication. They are available: not in the middle of the rain forest but right up in a local pharmacy some blocks away. These are the many known drugs that have not been studied thoroughly or have been brushed aside because of their generic status. If clinical trials can be conducted in a scale to establish efficacy of a known drug, it can be repurposed for the treatment of, say, cancer, a disease of huge social and economic burden. There were many successful examples of this approach.3, 4 Disulfiram, a drug with multiple targets for cancer control, costs less than a dollar a day and is being evaluated in a phase II clinical trial for prostate cancer, thanks to the generosity of philanthropist David Koch (Clinicaltrials.gov Identifier: NCT01118741). Although this is an exciting development based on promising preclinical data, it is only the start. More of such trials need to be done. Although we do not expect one drug to save the American Health system, the possibilities make any testing worthwhile. The question here on in lies in how the medical society moves to examine and redefine these old drugs for new answers. We completely agree with the notion that leading organizations and government should fund clinical research, especially clinical trials, to speed up the off-patent drug development process and eventually bring down painfully high costs.1 In addition, we should develop mechanisms to encourage profit-seeking manufacturers to be involved in these developmental processes. One option is a temporary revision of generic drug prices to compensate the manufacturer for the studies and ensure sufficient tax revenue for the government organization sponsoring such clinical trials. The benefits of raising generic drug prices by a few dollars far outweigh the cost to the individual consumer. Yours sincerely, Liz Zhe Lin, Jianqing Lin