# Systematic drug repurposing

Source: https://onco.cc/technologies/drug-repurposing/  
OnCo record `drug-repurposing` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Testing cheap old drugs, aspirin, metformin, statins, beta-blockers, as cancer treatments, because they are safe, available and sometimes work.

## Summary

Large randomised trials of repurposed agents have mostly been negative: metformin did not improve invasive disease-free survival in the adjuvant breast cancer trial MA.32 (NCT01101438), while aspirin continues to be tested for adjuvant benefit (Add-Aspirin, NCT02804815) and is established in Lynch syndrome prevention. AI screening of prescription and expression databases now proposes candidates faster than trials can test them, and funding for non-proprietary agents is the real bottleneck.

## Fields

- Kind: Technology
- Status: phase-3
- Last checked: 2026-09-08
- Tags: frontier
- Principle: Approved drugs with known safety are tested against cancer endpoints, either on mechanistic grounds or on signals mined from real-world prescription data.
- Strengths: Known safety and cost, so adoption is immediate if positive; Attractive for prevention and low-resource settings; AI can prioritise candidates from existing data
- Limitations: No commercial sponsor, so trials are slow and underfunded; Observational signals are heavily confounded; Major trials have been negative

## Sources

- MA.32 adjuvant metformin (NCT01101438): https://clinicaltrials.gov/study/NCT01101438
- Add-Aspirin (NCT02804815): https://clinicaltrials.gov/study/NCT02804815

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/)
- fronts: [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/), [Prevention & Risk](https://onco.cc/fronts/prevention/)
- technologies: [AI-driven drug & target discovery](https://onco.cc/technologies/ai-drug-design/), [Aspirin for cancer prevention and adjuvant therapy](https://onco.cc/technologies/aspirin-cancer-prevention/), [Chemoprevention & risk-reducing surgery](https://onco.cc/technologies/chemoprevention/), [Exercise & lifestyle oncology](https://onco.cc/technologies/exercise-oncology/)
- terms: [Real-world evidence](https://onco.cc/terms/real-world-evidence/)
- roadmaps: [Paths to cures: interception, eradication, control](https://onco.cc/roadmaps/cure-paths/), [Radical oncology: what could change the war by 2035](https://onco.cc/roadmaps/frontier-2035/)
- drugs: [Ivermectin](https://onco.cc/drugs/ivermectin/), [Mebendazole](https://onco.cc/drugs/mebendazole/)
- trials: [Add-Aspirin](https://onco.cc/trials/add-aspirin/), [ALASCCA](https://onco.cc/trials/alascca/), [ICONIC: ivermectin combined with immune checkpoint inhibition in cancer (University of Florida phase 2)](https://onco.cc/trials/nct07487805/), [Ivermectin with balstilimab or pembrolizumab in metastatic triple-negative breast cancer (Cedars-Sinai phase 1/2)](https://onco.cc/trials/nct05318469/), [Low-dose olanzapine for cancer anorexia (Tata Memorial)](https://onco.cc/trials/olanzapine-appetite-tmh/)
- key papers: [A phase 2a clinical study on the safety and efficacy of individualized dosed mebendazole in patients with advanced gastrointestinal cancer](https://onco.cc/key-papers/paper-mansoori-mebendazole-gi-cancer-phase-2a-sci-rep-2021/), [Ivermectin treatment for gynecologic cancers: hope versus hype](https://onco.cc/key-papers/paper-straughn-ivermectin-hope-versus-hype-2025/), [Ivermectin, a potential anticancer drug derived from an antiparasitic drug](https://onco.cc/key-papers/paper-tang-ivermectin-potential-anticancer-pharmacol-res-2021/), [Reverse swing-M, phase 1 study of repurposing mebendazole in recurrent high-grade glioma](https://onco.cc/key-papers/paper-patil-mebendazole-glioma-phase-1-cancer-med-2020/), [The multitargeted drug ivermectin: from an antiparasitic agent to a repositioned cancer drug](https://onco.cc/key-papers/paper-juarez-ivermectin-repositioned-cancer-drug-2018/)
- institutions: [The University of Kansas Cancer Center](https://onco.cc/institutions/ku-cancer-center/)

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