Abstract
Background: Despite years of success of most anti-cancer drugs, one of the major clinical
problems is inherent and acquired resistance to these drugs. Overcoming the drug resistance or developing
new drugs would offer promising strategies in cancer treatment. Disulfiram, a drug currently
used in the treatment of chronic alcoholism, has been found to have anti-cancer activity.
Objective: To summarize the anti-cancer effects of Disulfiram through a thorough patent review.
Methods: This article reviews molecular mechanisms and recent patents of Disulfiram in cancer therapy.
Results: Several anti-cancer mechanisms of Disulfiram have been proposed, including triggering oxidative
stress by the generation of reactive oxygen species, inhibition of the superoxide dismutase activity,
suppression of the ubiquitin-proteasome system, and activation of the mitogen-activated protein
kinase pathway. In addition, Disulfiram can reverse the resistance to chemotherapeutic drugs by inhibiting
the P-glycoprotein multidrug efflux pump and suppressing the activation of NF-kB, both of
which play an important role in the development of drug resistance. Furthermore, Disulfiram has been
found to reduce angiogenesis because of its metal chelating properties as well as its ability to inactivate
Cu/Zn superoxide dismutase and matrix metalloproteinases. Disulfiram has also been shown to inhibit
the proteasomes, DNA topoisomerases, DNA methyltransferase, glutathione S-transferase P1, and O6-
methylguanine DNA methyltransferase, a DNA repair protein highly expressed in brain tumors. The
patents described in this review demonstrate that Disulfiram is useful as an anti-cancer drug.
Conclusion: For years the FDA-approved, well-tolerated, inexpensive, orally-administered drug Disulfiram
was used in the treatment of chronic alcoholism, but it has recently demonstrated anti-cancer
effects in a range of solid and hematological malignancies. Its combination with copper at clinically
relevant concentrations might overcome the resistance of many anti-cancer drugs in vitro, in vivo, and
in patients.
Keywords:
Angiogenesis, cancer, cancer stem cells, cytotoxicity, disulfiram, inflammation, proteasome.
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