Drug repurposing, the practice of using an existing drug to treat diseases and conditions it was not intended for, was once considered a fringe idea. However, during the Covid-19 pandemic, the concept gained renewed interest. As the coronavirus raged around the world, there was an urgent need to develop treatments. Using existing drugs, which were already in circulation, proved to be a faster and cheaper route to develop treatments. Now, researchers are turning to drug repurposing to create more affordable and accessible treatments for cancers and rare diseases.
Last month, some of those researchers gathered in Kuala Lumpur for the Empowering Change - Drug Repurposing for Cancers and Rare Diseases in Malaysia Roundtable. The roundtable saw clinicians, researchers, patient advocates, and pharmaceutical representatives discussing both the current landscape and the huge potential for Malaysia to pioneer drug repurposing in Southeast Asia.
For Lily Tan, the potential of drug repurposing is meaningful both professionally and personally. Tan was on the panel Empowering Change Drug Repurposing for Cancers & Rare Diseases in Malaysia. As a breast cancer survivor, she understands on a personal level the difficulties that come with a cancer diagnosis. As a pharmacist in Sabah, Tan has seen firsthand how finances can prevent patients from accessing treatments. Despite the highly subsidised treatments available at government hospitals, Tan said many patients she meets through her work face the additional burden of high travel costs. They must travel long distances by boat, hired cars and even planes to Kota Kinabalu. The costs can run into hundreds of ringgit. Plus, travelling for treatment often means a loss of income. “[Patients] don’t seek treatment or seek alternative treatments because in many cases these extra costs make conventional treatment inaccessible,” she lamented.
One study in 2015 found that over 75% of newly diagnosed cancer patients in Southeast Asia will suffer death or “financial catastrophe” in the first year following diagnosis. The need for accessible treatments is spurring on the researchers. “Developing more affordable, effective and better-tolerated treatments for cancers are crucial, especially for patients in Malaysia, Asean and the Global South, where cancer is often a neglected disease,” said Dr Yolanda Augustin, an oncologist and researcher at City-St George’s University of London and Universiti Malaya. Dr Augustin is also part of the International Affordable Diagnostics and Therapeutics Alliance (IA-DATA), an initiative to transform access to life-saving diagnostics and therapeutics for neglected diseases, cancers and rare diseases across the Global South.
Drug repurposing offers hope not just for cancer patients, but those with rare diseases as well. Nadiah Hanim Abdul Latif, the president of the Malaysian Rare Disorders Society (MRDS), presented the importance of drug repurposing for those living with rare diseases. “Since ninety-five per cent of rare diseases do not have a known cure or medical intervention, drug repurposing is exciting because it gives hope for a shorter timeline for an accelerated treatment. It’s also an opportunity to expand the treatments available for rare diseases.” She also stressed that the lack of treatment for rare diseases had far-reaching impacts for the country. “The cost of inaction is increased healthcare expenditures, loss of productivity, higher social support costs, and ultimately lives.”
Professor Sanjeev Krishna, Em Professor of Molecular Parasitology and Medicine at City-St George’s University of London and Universiti Malaya highlights the need for developing solutions for patients in the Global South at speed. “IA-DATA represents a transformative opportunity for Malaysia and the ASEAN region to lead in drug repurposing and for accelerating the delivery of affordable diagnostics and therapies for cancers, infectious, and neglected diseases. By leveraging Malaysia’s research strengths and fostering open collaboration between government, academia, and industry, we are building equitable access to cutting-edge healthcare innovations—ensuring new hope where the need is greatest, and setting a template for innovation and partnership across the Global South,” he said, speaking at the drug repurposing roundtable.
Malaysia’s research ecosystem, which includes academic universities and the Ministry of Health, presents an opportunity for the country to take the lead on drug repurposing. Professor Ivy Chung, Lead Researcher at Universiti Malaya Affordable Diagnostics & Therapeutics Group (UMADT), believes Malaysia is uniquely positioned to advance drug repurposing. “At UMADT, we are integrating academic excellence and strategic partnerships with Government and Industry to accelerate the translation of laboratory discoveries into accessible therapies for patients with cancer and other major diseases.” UMADT’s initial work programme includes colorectal, nasopharyngeal and pre-cervical cancers. These cancers are among the top ten most commonly reported ones between 2021 - 2016.
Dr Augustin went on to elaborate that through the IA-DATA programme, there are two demonstrator projects which are Phase II clinical trials repurposing an anti-malarial drug called artesunate as a potential treatment for colorectal cancer and pre-cervical cancer. Artesunate is derived from Artemisia annua, a plant used for thousands of years in traditional Chinese Medicine (Qing Hao), and is affordable at less than RM5 per dose. These studies are now open to recruitment at Universiti Malaya and 9 other Ministry of Health Hospitals across Malaysia.
Malaysia could learn from the experience of REMEDi4ALL, a EU-funded consortium that addresses barriers to drug repurposing. The platform provides scientific tools, preclinical and clinical support, regulatory planning, patient engagement structures, and a funders network to align investment and avoid duplication. Dr Pan Pantziarka, Director of Drug Repurposing at the Anticancer Fund and member of REMEDi4ALL joined the roundtable by Zoom to share his experience. Dr Pantziarka stressed that coordination is important. Fragmented efforts, even if scientifically sound, may struggle without a national structure that aligns priorities, resources, and regulatory planning.
Ultimately, for cancer survivors like Chris Cheng, the president of the Society for Cancer Advocacy and Awareness, Kuching, affordable treatments are key. “For patients, what matters most is survival, affordability, and quality of life.” He stressed that access is very important: “Novel therapies are great, but can we access them? Can a villager from Belaga access the latest targeted therapy? The answer is probably not. But by using a drug repurposing approach, if we can reduce the cost to patients, then they will have better access to emerging cancer treatments.”
Germaine D’Oliveiro is a writer, teacher and freelance journalist. She writes about health, social issues, culture and art.
