Shared molecular, cellular, and environmental hallmarks in cardiovascular disease and cancer: any place for drug repurposing?

Cancer and cardiovascular disease (CVD) are the two biggest killers worldwide. Specific treatments have been developed for the two diseases. However, mutual therapeutic targets should be considered due to the overlap of cellular and molecular mechanisms. Cancer research has grown at a fast pace leading to an increasing number of new mechanistic treatments. Some of these drugs could prove useful for treating CVD, which realizes the concept of cancer drug repurposing. This review provides a comprehensive outline of the shared hallmarks of cancer and CVD, primarily ischemic heart disease and heart failure. We focus on chronic inflammation, altered immune response, stromal and vascular cell activation, and underlying signaling pathways causing pathological tissue remodeling. There is an obvious scope for targeting those shared mechanisms, thereby achieving reciprocal preventive and therapeutic benefits. Major attention is devoted to illustrating the logic, advantages, challenges, and viable examples of drug repurposing and discussing the potential influence of sex, gender, age, and ethnicity in realizing this approach. Artificial intelligence will help to refine the personalized application of drug repurposing to cardiovascular patients.