REPURPOSING OF ANTIFUNGAL DRUGS IN CANCER THERAPY – A FOCUS ON ITRACONAZOLE

Drug repurposing has emerged as a cost-effective and time-saving approach to identify new
therapeutic indications for existing drugs. Among antifungals, itraconazole has shown promising
anti-angiogenic and anti-proliferative activity in various cancers.This study explores the potential
of itraconazole and other azole antifungals in oncology, highlighting their mechanisms, clinical
findings, and future perspective.Beyond its antifungal activity, itraconazole inhibits the Hedgehog
signaling pathway, blocks vascular endothelial growth factor receptor 2 (VEGFR2), and
suppresses tumor angiogenesis. Preclinical and early clinical studies demonstrate its effectiveness
in non-small cell lung cancer, basal cell carcinoma, and prostate cancer. Repurposing such drugs
offers an advantage due to their established safety profile, pharmacokinetics, and affordability,
which is crucial for resource-limited settings like India. Furthermore, combining itraconazole with
conventional chemotherapeutics has shown synergistic effects in reducing tumor progression.
Repurposed antifungal agents, particularly itraconazole, represent a novel class of adjuvant
therapies in cancer management. Future large-scale randomized trials are warranted to validate
these findings and establish their role in standard oncology practice.
KEYWORDS: Itraconazole, Drug repurposing , Hedgehog pathway, Angiogenesis, Cancer
therapy.