Deciphering Riluzole: Illuminating Unexplored Avenues in Cancer Treatment through Mechanistic and Clinical Insights

Drug repositioning is a well established concept for therapeutic agents with well-recognized safety profiles and thoroughly described pharmacokinetic properties. Despite the advancement in oncology research, repositioning is imperative for anti-neoplastic activities to fill the gap of cancer therapy, the most unmet medical need today. Among various clinically accepted therapeutic agents, riluzole is a drug that has been shown to be effective in various cancers. However, it was primarily developed to treat and control amyotrophic lateral sclerosis, a fatal neurodegenerative disease. Riluzole recently exhibited to either limit cell growth or kill the cell after altering or affecting pathways like growth signalling, glutamate secretion, glutathione synthesis, Ca2+ homeostasis, generation of reactive oxygen species, nucleic acid integrity, autophagy, apoptosis, etc. Because of this multifaceted action, riluzole has been found to be effective in some malignancies originating from various tissues, including the nasopharynx, breast, colon, skin, bone, pancreas, and liver. The present review examined mechanistic pathways, effects of riluzole treatments on different types of cancers, pre-clinical evaluation, clinical status, and future perspectives of riluzole as an anticancer agent.