Cancer patients will be asked to pay thousands of pounds to test new drug treatments under a controversial trial.
Although the four drugs being used cost only a few pence each, the thousand patients in the trial will be asked to pay £450 to be included and £250 for each monitoring consultation every three months to assess how well the drugs are controlling or eliminating their cancer. Volunteers who absolutely cannot afford the charges will be offered the treatment free.
The study, which has been approved by the Medicines and Healthcare Products Regulatory Agency, is the first in which patients have been asked to pay to be included. It has been proposed out of desperation because the four drugs are not patented and there is no commercial incentive for pharmaceutical companies to fund an NHS trial that would cost many millions of pounds.
The four drugs on trial are statins, which are normally used for heart disease; metformin, which is routinely used to treat diabetes; the antibiotic doxycycline, normally used for acne; and an anti-parasitic drug called mebendazole, used to treat intestinal worms in children. Trials around the world have shown that all four drugs can target and destroy fast-replicating cancer cells, but they are not routinely issued to cancer patients.
The trial is being led by Justin Stebbing, of Imperial College London, and will be carried out at the private Care Oncology Clinic (COC) in London.
Professor Stebbing said that the trial subjects could be suffering from any form of cancer. They will take the drugs on top of whatever anti-cancer drug treatment they are already receiving. He said: “There’s a lot of existing data on these drugs showing they improve cancer survival. We have enough data ourselves to publish already from what we have done so far, but the new trial will start within six months.”
The trial is also controversial because patients will volunteer rather than being randomly selected, but Professor Stebbing believes it is the only way forward. “We have to do this work on repurposed drugs,” he said. “There is evidence they can treat Alzheimer’s and a variety of other conditions but at the moment it just isn’t happening.”
It is hoped that the data from the trial will be sufficiently compelling to force the introduction of the repurposed drugs into NHS care, with the intention of putting all four of the drugs into a once-a-day pill.
The COC, which employs a team of doctors liaising with patients’ NHS cancer consultants, has been operating since September 2014. Some of its patients already on the four-drug regime have done well. Thomas McDermott, 72, had brain cancer diagnosed in 2014 and was given 12 to 14 months to live. He has been on the COC regime since July 2015. “My NHS consultant says I have defied Western medicine,” he said.
What the drugs do
- Statins: Boost production of cell-death proteins normally knocked out of cancer cells; reduce the availability of cholesterol needed for production in tumour cells
- Metformin: Blocks a cell-signalling pathway used for the replication of cancer cells; alters the effect of malfunctioning proteins that promote immortality in cancer cells
- Doxycycline: Breaks down energy-giving mitochondria; blocks activity that lets cancer cells migrate
- Mebendazole: Fatally disrupts structures needed for cancer cells to divide; activates cell-death proteins