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      Giving Drugs a Second Chance: Overcoming Regulatory and Financial Hurdles in Repurposing Approved Drugs As Cancer Therapeutics

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          Abstract

          The repositioning or “repurposing” of existing therapies for alternative disease indications is an attractive approach that can save significant investments of time and money during drug development. For cancer indications, the primary goal of repurposed therapies is on efficacy, with less restriction on safety due to the immediate need to treat this patient population. This report provides a high-level overview of how drug developers pursuing repurposed assets have previously navigated funding efforts, regulatory affairs, and intellectual property laws to commercialize these “new” medicines in oncology. This article provides insight into funding programs (e.g., government grants and philanthropic organizations) that academic and corporate initiatives can leverage to repurpose drugs for cancer. In addition, we highlight previous examples where secondary uses of existing, Food and Drug Administration- or European Medicines Agency-approved therapies have been predicted in silico and successfully validated in vitro and/or in vivo (i.e., animal models and human clinical trials) for certain oncology indications. Finally, we describe the strategies that the pharmaceutical industry has previously employed to navigate regulatory considerations and successfully commercialize their drug products. These factors must be carefully considered when repurposing existing drugs for cancer to best benefit patients and drug developers alike.

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          Most cited references49

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          The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease.

          To pursue a systematic approach to the discovery of functional connections among diseases, genetic perturbation, and drug action, we have created the first installment of a reference collection of gene-expression profiles from cultured human cells treated with bioactive small molecules, together with pattern-matching software to mine these data. We demonstrate that this "Connectivity Map" resource can be used to find connections among small molecules sharing a mechanism of action, chemicals and physiological processes, and diseases and drugs. These results indicate the feasibility of the approach and suggest the value of a large-scale community Connectivity Map project.
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            Drug repositioning: identifying and developing new uses for existing drugs.

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              Diagnosing the decline in pharmaceutical R&D efficiency.

              The past 60 years have seen huge advances in many of the scientific, technological and managerial factors that should tend to raise the efficiency of commercial drug research and development (RD). Yet the number of new drugs approved per billion US dollars spent on RD has halved roughly every 9 years since 1950, falling around 80-fold in inflation-adjusted terms. There have been many proposed solutions to the problem of declining RD efficiency. However, their apparent lack of impact so far and the contrast between improving inputs and declining output in terms of the number of new drugs make it sensible to ask whether the underlying problems have been correctly diagnosed. Here, we discuss four factors that we consider to be primary causes, which we call the 'better than the Beatles' problem; the 'cautious regulator' problem; the 'throw money at it' tendency; and the 'basic research-brute force' bias. Our aim is to provoke a more systematic analysis of the causes of the decline in RD efficiency.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                14 November 2017
                2017
                : 7
                : 273
                Affiliations
                [1] 1Department of Molecular Genetics, Faculty of Medicine, University of Toronto , Toronto, ON, Canada
                [2] 2Lunenfeld-Tanenbaum Research Institute , Toronto, ON, Canada
                [3] 3The Hospital for Sick Children , Toronto, ON, Canada
                [4] 4Cyclica Inc. , Toronto, ON, Canada
                Author notes

                Edited by: Nicolas Andre, Assistance Publique Hôpitaux de Marseille, France

                Reviewed by: Antonio Rozzi, Istituto Neurotraumatologico Italiano Grottaferrata (Roma), Italy; Pan Pantziarka, Anticancer Fund, Belgium; Thomas J. Anastasio, University of Illinois at Urbana, Champaign, United States

                *Correspondence: Steven V. Molinski, steven.molinski@ 123456cyclicarx.com

                These authors have contributed equally to this work.

                Specialty section: This article was submitted to Cancer Molecular Targets and Therapeutics, a section of the journal Frontiers in Oncology

                Article
                10.3389/fonc.2017.00273
                5694537
                29184849
                bce8c8de-3ca7-4e70-86e7-5bc1c914740b
                Copyright © 2017 Hernandez, Pryszlak, Smith, Yanchus, Kurji, Shahani and Molinski.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 29 June 2017
                : 30 October 2017
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 48, Pages: 8, Words: 5933
                Categories
                Oncology
                Mini Review

                Oncology & Radiotherapy
                drug repurposing,funding opportunities,in silico predictions,in vitro validation,intellectual property laws,oncology indications,regulatory approval

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