Abstract
BackgroundExpensive cancer treatment calls for alternative ways such as drug repurposing to develop effective drugs. The aim of this study was to analyse the effect of post-diagnostic use of cholera vaccine on survival outcome in breast cancer patients.MethodsCancer diagnosis and cholera vaccination were obtained by linkage of several Swedish national registries. One vaccinated patient was matched with maximum two unvaccinated individuals based on demographic, clinical and socioeconomic factors. We performed proportional Cox regression model to analyse the differences in overall and disease-specific survivals between the matched patients.ResultsIn total, 617 patients received cholera vaccine after breast cancer diagnosis. The median (interquartile range) time from diagnosis to vaccination was 30 (15–51) months and from vaccination to the end of follow-up it was 62 (47–85) months. Among them, 603 patients were matched with 1194 unvaccinated patients. Vaccinated patients showed favourable overall survival (hazard ratio (HR): 0.54, 95% confidence interval (CI): 0.37–0.79) and disease-specific survival (HR: 0.53, 95% CI: 0.33–0.84), compared to their unvaccinated counterpart. The results were still significant in multiple sensitivity analyses.ConclusionsPost-diagnostic use of cholera vaccine is associated with a favourable survival rate in breast cancer patients; this provides evidence for repurposing it against breast cancer.
Highlights
Expensive cancer treatment calls for alternative ways such as drug repurposing to develop effective drugs
603 vaccinated patients were able to match with 1194 unvaccinated individuals
After matching 444 patients with 873 individuals without antimalarial medication, we found that antimalarial medication was not significantly associated with disease-specific survival (HR: 1.14, 95% confidence interval (CI): 0.57–2.29)
Summary
Expensive cancer treatment calls for alternative ways such as drug repurposing to develop effective drugs. It is estimated that a typical drug development usually takes 15–18 years and costs approximately 2–3 billion dollars.[2] In a clinical setting, cancer patients and their involved family members suffer from the pressure of meeting the costs of these expensive cancer drugs financially as well as the emotional burden associated with the treatment Some of these expensive cancer drugs are not covered by the public healthcare system in many developing countries leading to a higher mortality rate among insolvent patients with breast cancer.[3] In this scenario, drug repurposing is an alternative and efficient way for drug development, which identifies the new indication of the drug outside the scope of the original medical condition. Raloxifene, which was originally used to treat osteoporosis, was approved by the U.S Food and Drug Administration for invasive breast cancer treatment in 2007.4
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