Randomise a cheap antihistamine alongside immunotherapy
Patients who happened to take common allergy pills during immunotherapy seemed to live longer in a large records study. A simple randomised trial would show whether the pills really help.
A 2022 analysis of MD Anderson records (Li and colleagues, Cancer Cell) found that H1-antihistamine use during checkpoint inhibitor therapy was associated with improved survival in melanoma and lung cancer, with mechanistic work suggesting histamine-HRH1 signalling in macrophages drives T-cell dysfunction. Antihistamines cost pennies and are extremely safe. The proposal is a placebo-controlled randomised trial of a non-sedating H1-antihistamine (for example fexofenadine or loratadine) added to standard checkpoint inhibitor therapy in non-small cell lung cancer, with a plasma histamine biomarker sub-study.
- No incentive to repurpose cheap drugs · Old, cheap drugs with anti-cancer signals never get the trials they need because no one profits from the result.
- No one can predict who responds to immunotherapy · Checkpoint drugs cure some patients and do nothing for most. We still cannot tell the two apart before treating.
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not linked directly; found by shared links- IdeaTest a high-fibre diet as an immunotherapy adjunct
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