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Study breakdown

NK-1 Receptor Blocker Aprepitant Kills Cancer Cells but Also Harms Normal Cells — Peptide Alternative Falls Short

In VitroLow Moderate evidence
The takeaway

The anti-nausea drug aprepitant potently reduced cancer cell proliferation but was equally toxic to normal cells, while the peptide NK-1 antagonist showed minimal anticancer activity.

Not selective

Aprepitant was equally toxic to cancer and normal cell lines, contradicting previous claims of cancer selectivity

What the researchers found

Aprepitant potently reduced cancer cell proliferation but was not selective (equally toxic to normal cells); the peptide NK-1 antagonist showed minimal anticancer activity even at 100 µM.

Why it matters

Challenges the idea that NK-1 receptor blockers are selective cancer treatments. Aprepitant's lack of selectivity limits its potential as an anti-cancer drug despite strong antiproliferative effects.

The numbers in context

Aprepitant potent in all 5 cancer lines but also in 3 normal lines; peptide antagonist effective only at 100 uM in few lines; no colony formation effect

How the study worked

In vitro: 5 cancer + 3 normal cell lines; cell proliferation test, MTT assay, and colony formation assay; aprepitant vs [D-Pro2, D-Trp7,9]-Substance P at multiple concentrations.

Who was studied

5 cancer cell lines and 3 normal cell lines treated with aprepitant or [D-Pro2,D-Trp7,9]-Substance P

What this study cannot tell us

In vitro only; limited cell line panel; peptide antagonist concentrations may not be pharmacologically relevant; aprepitant's non-selectivity may be dose-dependent.

How to read the evidence

Low-moderate — well-designed comparative study but limited by in vitro methodology and small cell line panel.

When this study was published

Published in 2020; NK-1R as a cancer target remains debated.

The bigger picture

The substance P/NK-1R cancer connection generated excitement, but this study suggests the anticancer effects of NK-1 antagonists may be non-specific cytotoxicity rather than targeted anti-cancer action.

Questions still open

  • Are the anticancer effects of aprepitant NK-1R-mediated or due to off-target cytotoxicity?
  • Could lower, clinically achievable aprepitant concentrations show cancer selectivity?
  • Are there other NK-1R antagonists with better selectivity profiles?

Common questions

Could anti-nausea drugs treat cancer?
Aprepitant (used for chemotherapy nausea) kills cancer cells in lab tests, but this study found it equally kills normal cells — meaning it's likely not a targeted cancer treatment.
Why didn't the peptide antagonist work well?
The peptide version was much less potent than the small molecule aprepitant, only showing effects at very high concentrations that may not be achievable in the body.

Read the original research

Antiproliferative effects of [D-Pro2, D-Trp7,9]-Substance P and aprepitant on several cancer cell lines and their selectivity in comparison to normal cells.

Folia neuropathologica, 58(3), 237-244

Citation

Matalińska, Joanna; Świć, Agnieszka; Lipiński, Piotr; Misicka, Aleksandra. (2020). Antiproliferative effects of [D-Pro2, D-Trp7,9]-Substance P and aprepitant on several cancer cell lines and their selectivity in comparison to normal cells.. Folia neuropathologica, 58(3), 237-244. https://doi.org/10.5114/fn.2020.100066