aliskiren + aspirin + celecoxib + cilazapril + curcumin + metformin + propranolol

This experimental seven-drug combination therapy is designed to target the renin-angiotensin system (RAS) and its converging pathways, which are implicated in the maintenance and proliferation of glioblastoma stem cells. The regimen consists of aliskiren (a renin inhibitor), cilazapril (an ACE inhibitor), propranolol (a non-selective beta-blocker), aspirin and celecoxib (anti-inflammatory COX inhibitors), metformin (an antidiabetic AMPK activator), and curcumin (a natural compound typically administered with piperine). A Phase I clinical trial conducted by researchers at the Gillies McIndoe Research Institute (O'Rawe et al.) evaluated this combination in patients with relapsed glioblastoma who had failed standard-of-care treatments. The study reported that the therapy was well-tolerated and showed a trend toward improved median survival (19.9 months vs. 14.6 months for standard therapy), suggesting that simultaneous inhibition of multiple RAS-related pathways may provide a novel therapeutic strategy for aggressive brain tumors.