CUSP9
CUSP9 is a chemotherapy protocol designed for the treatment of glioblastoma, a type of brain tumor. The protocol involves the use of nine repurposed drugs, hence the name CUSP9. The drugs are used in conjunction with temozolomide, a standard chemotherapy drug for glioblastoma.
Background
Glioblastoma is the most common and aggressive primary brain tumor in adults. Despite advances in surgery, radiation therapy, and chemotherapy, the prognosis for patients with glioblastoma remains poor, with a median survival of approximately 15 months. The CUSP9 protocol was developed in response to the need for more effective treatments.
Protocol
The CUSP9 protocol involves the use of nine repurposed drugs: aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, ritonavir, and sertraline. These drugs were chosen based on their ability to target multiple pathways involved in glioblastoma growth and survival. The drugs are used in conjunction with temozolomide, a standard chemotherapy drug for glioblastoma.
Mechanism of Action
Each of the nine drugs in the CUSP9 protocol targets a different aspect of glioblastoma biology. For example, aprepitant inhibits the neurokinin-1 receptor, which is overexpressed in glioblastoma cells. Artesunate is an anti-malarial drug that also has anti-cancer properties, including the ability to induce apoptosis in cancer cells. Auranofin is an anti-rheumatic drug that inhibits the enzyme thioredoxin reductase, which is overexpressed in many cancers. Captopril, celecoxib, disulfiram, itraconazole, ritonavir, and sertraline also have mechanisms of action that make them potentially effective against glioblastoma.
Clinical Trials
As of 2021, the CUSP9 protocol is being tested in clinical trials. Preliminary results suggest that the protocol may be safe and potentially effective, but more research is needed to confirm these findings.
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Contributors: Prab R. Tumpati, MD