TY - JOUR
T1 - Repurposing tranexamic acid as an anticancer drug
T2 - a systematic review and meta-analysis
AU - Kristjansen, Karoline Assifuah
AU - Djebbara-Bozo, Nulvin
AU - Nanthan, Kumanan Rune
AU - Bønnelykke-Behrndtz, Marie Louise
PY - 2025/5
Y1 - 2025/5
N2 - Purpose: Drug repurposing may be an efficient strategy for identifying new cancer treatments. Tranexamic acid (TXA), an antifibrinolytic agent that affects the plasminogen-plasmin pathway, may have potential anticancer effects by influencing tumor cell proliferation, angiogenesis, inflammation, immune response, and tissue remodeling—all crucial processes contributing to tumor progression and metastasis. Objective: Evaluate TXA’s anticancer effects across in vitro, animal, and clinical studies to assess its potential as a repurposed cancer drug. Methods: The study was designed as a PRISMA-compliant systematic review and meta-analysis. The literature search was conducted in MEDLINE, EMBASE, Web of Science, and the Cochrane Library. In vitro, animal, and clinical studies investigating the anticancer effects of TXA or epsilon-aminocaproic acid (EACA) were included. Animal and clinical studies were critically appraised, and studies with a low risk of bias were included in the meta-analysis. Results: Of 4367 identified records, 38 articles were included, collectively reporting findings from 41 in vitro studies, 34 animal studies (n = 843 animals), and seven clinical studies (n = 91 patients). The meta-analysis included nine animal studies and showed a tumor growth reduction in animals treated with TXA compared to controls with a standardized mean difference of – 1.0 (95%CI – 1.5; – 0.4) (p = 0.0002). Equivalently, the majority of in vitro studies reported reduced proliferation, viability, and invasiveness in TXA-exposed tumor cell lines. The clinical studies were considerably susceptible to bias, rendering any conclusions futile. Conclusions: TXA shows promise as a repurposed cancer drug, revealing an overall reduction in tumor growth, viability, and invasiveness in animal and in vitro studies.
AB - Purpose: Drug repurposing may be an efficient strategy for identifying new cancer treatments. Tranexamic acid (TXA), an antifibrinolytic agent that affects the plasminogen-plasmin pathway, may have potential anticancer effects by influencing tumor cell proliferation, angiogenesis, inflammation, immune response, and tissue remodeling—all crucial processes contributing to tumor progression and metastasis. Objective: Evaluate TXA’s anticancer effects across in vitro, animal, and clinical studies to assess its potential as a repurposed cancer drug. Methods: The study was designed as a PRISMA-compliant systematic review and meta-analysis. The literature search was conducted in MEDLINE, EMBASE, Web of Science, and the Cochrane Library. In vitro, animal, and clinical studies investigating the anticancer effects of TXA or epsilon-aminocaproic acid (EACA) were included. Animal and clinical studies were critically appraised, and studies with a low risk of bias were included in the meta-analysis. Results: Of 4367 identified records, 38 articles were included, collectively reporting findings from 41 in vitro studies, 34 animal studies (n = 843 animals), and seven clinical studies (n = 91 patients). The meta-analysis included nine animal studies and showed a tumor growth reduction in animals treated with TXA compared to controls with a standardized mean difference of – 1.0 (95%CI – 1.5; – 0.4) (p = 0.0002). Equivalently, the majority of in vitro studies reported reduced proliferation, viability, and invasiveness in TXA-exposed tumor cell lines. The clinical studies were considerably susceptible to bias, rendering any conclusions futile. Conclusions: TXA shows promise as a repurposed cancer drug, revealing an overall reduction in tumor growth, viability, and invasiveness in animal and in vitro studies.
KW - Anticancer agents
KW - Antifibrinolytics
KW - Cancer therapy
KW - Drug repurposing
KW - Systematic review
KW - Tranexamic acid
UR - https://www.scopus.com/pages/publications/105004696070
U2 - 10.1007/s00432-025-06185-y
DO - 10.1007/s00432-025-06185-y
M3 - Review
C2 - 40343490
AN - SCOPUS:105004696070
SN - 0171-5216
VL - 151
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
IS - 5
M1 - 157
ER -