# Anticancer Mechanisms

Itraconazole is being repurposed in oncology because it appears to act on multiple cancer-relevant pathways beyond its original antifungal use.

### Primary mechanisms

#### 1. Hedgehog pathway inhibition

* one of itraconazole's best-known repurposing mechanisms
* relevant in cancers driven by aberrant Hedgehog signalling

#### 2. Angiogenesis inhibition

* suppresses VEGFR2-related signalling
* reduces tumour microvessel density
* limits tumour blood-vessel growth

#### 3. AKT / mTOR pathway inhibition

* interferes with tumour survival and growth signalling
* relevant in resistant and aggressive tumour biology

#### 4. Wnt / β-catenin pathway modulation

* affects stem-like and proliferative signalling
* supports its broader anti-survival profile

#### 5. Tubulin- and proliferation-related disruption

* in some models, the broader impact on proliferation and division adds to the anti-tumour effect

#### 6. Multidrug-resistance reversal

* may interfere with drug-resistance systems that help tumour cells survive standard treatment

### Practical interpretation

Itraconazole is especially interesting because it hits several pathways that matter in resistant or angiogenesis-heavy cancers, which is why it continues to attract attention as a repurposed adjunct.

### Key References

Repurposing itraconazole for the treatment of cancer\
<https://pmc.ncbi.nlm.nih.gov/articles/PMC6769799/>

Repurposed itraconazole for use in the treatment of malignancies as a promising therapeutic strategy\
<https://www.sciencedirect.com/science/article/abs/pii/S1043661821003328>

Discovery of novel VEGFR-2 inhibitors from mebendazole\
<https://papers.ssrn.com/sol3/Delivery.cfm/3e62d80d-126c-4f09-a324-f81ec7aeae21-MECA.pdf?abstractid=5314948&mirid=1>

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