Repurposing angina pectoris medication as lung cancer treatment | Anticancerfund

Repurposing angina pectoris medication as lung cancer treatment

Nitroglycerin as a sensitiser in the treatment of non-small cell lung cancer: a phase II trial.

Cancer types
  • Lung cancer
Trial phase


ACF donation
Trial cost

Why this trial?

Lung cancer is still one of the most common cancers, with non-small cell lung cancer the most frequently occurring subtype. The treatment of non-small lung cancer is difficult, as tumours often do not respond sufficiently to available treatments. One of the reasons for this may be a lack of oxygen in the tumour. Tumours, due to their rapid growth, often do not have enough time to develop a sufficient blood supply system. This causes a lack of oxygen, which is required for radiotherapy to be effective. A better blood supply in the tumour could increase oxygen levels and sensitise the cancer cells to radiotherapy. One of the drugs that can be used to increase the blood supply in tissues is nitroglycerin.

Further research is needed to validate this hypothesis. The effect of nitroglycerin on radiation therapy in patients has not been studied in depth.

Why this drug?

Nitroglycerin has been on the market for to improve blood flow after a heart attack. It is a safe, effective and cheap drug with a low level of side effects. Previous research in animals has shown that the use of nitroglycerin can enhance sensitivity to radiation and chemotherapy in cancer by increasing the tumour blood flow.

If it was shown that nitroglycerin could improve survival by enhancing the effect of radiotherapy, this could be a safe, effective and low-cost lung cancer treatment.

Trial design

To study the effect of nitroglycerin in non-small cell lung cancer on survival, 60 patients were enrolled in this single centre non-randomized phase II trial. All patients were given nitroglycerin patches during their radiotherapy treatment. The effect of nitroglycerin on the blood supply and oxygen levels in the tumours was measured.


The trial was closed after 47 patients had been enrolled because an intermediate analysis found that nitroglycerin was unlikely to increase survival of lung cancer patients. The final results are currently being analysed by the research team.



  • Prof. Philippe Lambin, University Hospital Maastricht/MAASTRO Clinic, Maastricht, The Netherlands (Principal Investigator)
  • Dr. Bart Reymen, University Hospital Maastricht/MAASTRO Clinic, The Netherlands (Trial Coordinator)


  • MAASTRO Clinic, Maastricht, The Netherlands

Our role

financial support
Why we support this trial
Intervention has little or no commercial value
Expected survival benefit
No major hurdle for clinical implementation
Matching focus area


Trial cost
ACF donation
ACF internal support (2015-2017)
Questions about this trial?
The Anticancer Fund
studies [at]


More info on NCT01210378

Jordan BF, Misson P, Demeure R, et al. Changes in tumor oxygenation/perfusion induced by the no donor, isosorbide dinitrate, in comparison with carbogen: monitoring by EPR and MRI. Int J Radiat Oncol Biol Phys 2000;48:565-570.

Konovalova NP, Goncharova SA, Volkova LM, et al. Nitric oxide donor increases the efficiency of cytostatic therapy and retards the development of drug resistance. Nitric Oxide 2003;8:59-64.

Ng QS, Goh V, Fichte H, et al. Lung cancer perfusion at multi-detector row CT: reproducibility of whole tumor quantitative measurements. Radiology 2006;239:547-553.

Yasuda H, Nakayama K, Watanabe M, et al. Nitroglycerin treatment may enhance chemosensitivity to docetaxel and carboplatin in patients with lung adenocarcinoma. Clin Cancer Res 2006;12:6748-6757.

Yasuda H, Yamaya M, Nakayama K, et al. Randomized phase II trial comparing nitroglycerin plus vinorelbine and cisplatin with vinorelbine and cisplatin alone in previously untreated stage IIIB/IV non-small-cell lung cancer. J Clin Oncol 2006;24:688-694.