Novel treatment of patients with Advanced Cancers using a combination of commonly available, low cost oral medications.

This is an interventional study aimed at modulating the Renin angiotension system (RAS) using a cocktail of existing medications in common use. Many epidemiological studies have shown reduced incidence of cancer and improved survival of patients taking RAS modulators eg ßblocker, ATRB, ACE inhibitors (ACEi), Aspirin (a COX2 inhibitor) and Metformin. Cathepsin B expression is associated with higher tumour grades and reduced survival in patients with Oral cavity squamous cell carcinoma (OCSCC). Treatment of Curcumin (inhibitor of cathepsin B), improves survival of OCSCC patients. Combined use of Aspirin, Propranolol and Metformin to treat breast cancer has been recently proposed. Our study adds Curcumin, Cilazapril (an ACEi) or Losartan (an ATRB) and Aliskerin (a PRR blocker) to treat cancer. All medications are taken orally and are escalated at the discretion of the study doctor. Patients are reviewed fortnightly after their initial acceptance onto the trial. To ensure patient's are compliant with taking the medication they are initially given only two weeks at a time of required medications with a coloured chart of what the medications look like and when to take them. Patient's are advised to have a support person to assist with taking the medications accurately. The patient's verbal information regarding any side effects, as well as physical responses such as Blood pressure, pulse and physical examination by the study doctor will determine whether the medication will be escalated. Each oral medication stays the same or is escalated over a 3 month period and adjusted according to the patients responses. Aliskerin (oral) 150mgs once a day (stays the same throughout trial (day 1-36 months). Asprin (oral) 100mgs once a day (stays the same throughout trial (day 1-36 months). Celecoxib(oral) 200mgs once a day (stays the same throughout trial (day 1-36 months). Curcumin with Piperine 1000mgs (oral) twice a day (stays the same throughout trial (day 1-36mths). Omeprazole 20mgs (Oral) daily (day 1-36 months). Metformin (Oral) escalates from 250mgs daily (day 1 for 14), 250mgs twice a day for 14 days, 500mgs morning and 250mgs at night for 14 days, finally 500mgs twice daily for duration of the study. Propranolol(Oral)escalates from 40mgs twice daily(commenced week 2 for 14 days), 80mgs morning and 40mgs at night from week 4 for duration of study. Cilazapril (Oral)escalates from 1.25mgs once a day from week 6 for 14 days, 2.5mgs from week 8 for 14 days, 5mgs from week 10 for duration of study. Losarten (Oral)escalates from 50mgs once a day(week 6 for 14 days)50mgs twice a day(8 to 10 weeks) to 50mgs three times a day for the duration of the study.(this drug is the alternative if Cilazapril not tolerated). Baseline scan and bloods are taken and repeated at intervals as per protocol approved by HDEC. The overall observation period is 36 months or until the patient exists the study through choice or can no longer continue due to general decline.