From the Guidelines
Doxycycline is not used to treat renal cancer. The most recent and highest quality study, published in 2022 by the European Association of Urology 1, provides evidence-based guidelines for the management of patients with renal cell carcinoma (RCC) and does not mention doxycycline as a treatment option. Renal cancer treatment typically involves different approaches such as surgery, targeted therapy drugs (like sunitinib, pazopanib, or cabozantinib), immunotherapy agents (such as nivolumab or pembrolizumab), or in some cases radiation therapy, as recommended by the National Comprehensive Cancer Network (NCCN) guidelines 1. Doxycycline, an antibiotic in the tetracycline class, is primarily used to treat bacterial infections such as respiratory tract infections, urinary tract infections, acne, rosacea, and certain sexually transmitted infections, and its mechanism of action is not relevant to the treatment of renal cancer.
Some key points to consider when treating renal cancer include:
- The importance of histologic diagnosis and tumor staging in determining the best course of treatment
- The use of systemic therapy options, such as kinase inhibitors, mTOR inhibitors, and monoclonal antibodies, for patients with relapsed or stage IV disease
- The recommendation for combination axitinib/pembrolizumab as a treatment option for relapsed or stage IV clear cell renal cell carcinoma, as stated in the NCCN guidelines 1
- The need for regular follow-up and surveillance to monitor disease progression and response to treatment, as emphasized in the European Association of Urology guidelines 1.
Overall, while doxycycline may have potential anticancer properties, it is not currently an established or approved treatment for renal cancer in standard clinical practice, and treatment should be guided by evidence-based guidelines and recommendations from reputable organizations.
From the Research
Doxycycline and Renal Cancer
- Doxycycline (doxy) has been studied in the context of renal cancer, with some research exploring its potential as a treatment or adjunct therapy 2, 3.
- A Phase II study from 2006 investigated the combination of interferon-alpha and doxycycline for advanced renal cell carcinoma, but found that the regimen was not efficacious as treatment for renal cell carcinoma 2.
- However, a more recent study from 2021 found that doxycycline sensitizes renal cell carcinoma to chemotherapy by preferentially inhibiting mitochondrial translation, suggesting that it may be a useful addition to the treatment strategy for RCC 3.
- Another study from 2018 found that doxycycline attenuates cisplatin-induced acute kidney injury through pleiotropic effects, which could be relevant to the treatment of renal cancer patients receiving cisplatin-based chemotherapy 4.
Mechanism of Action
- Doxycycline has been shown to act on renal cell carcinoma cells via preferentially inhibiting mitochondrial DNA translation, thereby disrupting multiple mitochondrial complexes and impairing mitochondrial respiration 3.
- The drug has also been found to have anti-inflammatory, antioxidative, and matrix metalloproteinase (MMP)-inhibiting actions, which could contribute to its potential therapeutic effects in renal cancer 4.
Clinical Relevance
- Doxycycline may be given in the same dosage as where renal function is normal, as it does not require dosage adjustment for renal failure 5, 6.
- The drug is well tolerated, with the most frequent adverse effects being stomach upset, nausea, and diarrhea, but new formulations that reduce these manifestations are now available 5.