High Risk for Recurrence of Cancer

The National Comprehensive Cancer Network recommends specific guidelines for cancer treatment depending on tissue of origin and stage. There are cancers that are considered “high risk,” meaning, there is an increased likelihood of either recurrence or metastatic spread. For example, triple negative breast cancer is the most aggressive breast cancer, and NCCN guidelines suggests neoadjuvant chemotherapy (chemotherapy prior to surgery) and/or adjuvant chemotherapy (chemotherapy after surgery) for 4 cycles. Similarly, colon cancer that involves the lymph nodes, carries an increased risk for recurrence and or metastatic spread, and again, NCCN guidelines recommend adjuvant chemotherapy. Unfortunately, with these “high risk” cancers, there is a higher likelihood that there will be a recurrence. Standard guidelines have no further recommendations following adjuvant chemotherapy; we simply watch and wait.

Ammonium tetrathiomolybdate (TM) is an oral copper chelator, that was originally developed to treat Wilson’s disease, which is an inherited disease in which the individual is unable to excrete excess copper. This drug binds to copper and causes excretion of the copper in the stool, thereby lowering the individuals copper levels. Copper is essential for activation of many growth factors for cancer. By inactivating cancer growth factors, through copper depletion, TM is extremely effective at preventing angiogenesis (development of new blood vessels for cancer growth), and thereby, decreasing cancer recurrence and progression. Multiple studies have been performed with TM, yet despite its efficacy, the drug has received little fanfare. The primary reason for the lack of attention to the efficacy of this drug is that TM is no longer produced by the pharmaceutical industry. The patent on this drug has long expired, and with Wilson’s disease being a rare disorder, there is no monetary incentive for the pharmaceutical industry to participate in the manufacturing process.

For further information, including human trials performed with TM, please see powerpoint presentation.