Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis

Abstract 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, inflammati...

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Main Authors: Karoline Assifuah Kristjansen, Nulvin Djebbara-Bozo, Kumanan Rune Nanthan, Marie Louise Bønnelykke-Behrndtz
Format: Article
Language:English
Published: Springer 2025-05-01
Series:Journal of Cancer Research and Clinical Oncology
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Online Access:https://doi.org/10.1007/s00432-025-06185-y
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author Karoline Assifuah Kristjansen
Nulvin Djebbara-Bozo
Kumanan Rune Nanthan
Marie Louise Bønnelykke-Behrndtz
author_facet Karoline Assifuah Kristjansen
Nulvin Djebbara-Bozo
Kumanan Rune Nanthan
Marie Louise Bønnelykke-Behrndtz
author_sort Karoline Assifuah Kristjansen
collection DOAJ
description Abstract 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.
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spelling doaj-art-0a1751f226e84ca18d7c1ffb2ec529e72025-08-20T02:06:23ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-05-01151511310.1007/s00432-025-06185-yRepurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysisKaroline Assifuah Kristjansen0Nulvin Djebbara-Bozo1Kumanan Rune Nanthan2Marie Louise Bønnelykke-Behrndtz3Department of Clinical Medicine, Aarhus UniversityDepartment of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, RigshospitaletDepartment of Otorhinolaryngology, Head and Neck Surgery and Audiology, Aalborg University HospitalDepartment of Clinical Medicine, Aarhus UniversityAbstract 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.https://doi.org/10.1007/s00432-025-06185-yTranexamic acidDrug repurposingCancer therapyAnticancer agentsSystematic reviewAntifibrinolytics
spellingShingle Karoline Assifuah Kristjansen
Nulvin Djebbara-Bozo
Kumanan Rune Nanthan
Marie Louise Bønnelykke-Behrndtz
Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis
Journal of Cancer Research and Clinical Oncology
Tranexamic acid
Drug repurposing
Cancer therapy
Anticancer agents
Systematic review
Antifibrinolytics
title Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis
title_full Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis
title_fullStr Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis
title_full_unstemmed Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis
title_short Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis
title_sort repurposing tranexamic acid as an anticancer drug a systematic review and meta analysis
topic Tranexamic acid
Drug repurposing
Cancer therapy
Anticancer agents
Systematic review
Antifibrinolytics
url https://doi.org/10.1007/s00432-025-06185-y
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