Repurposing mebendazole to reprogram oncogenic and tumor-suppressor networks: Multi-cancer insights from ENOX2, MMP2, RASSF1A, WFDC10A and METTL7A

BACKGROUND: Cancer progression involves coordinated regulation of oncogenes and tumor suppressors. This study explores the interplay of ENOX2 (ecto-NADH oxidase disulfide-thiol exchanger 2), MMP2 (matrix metalloproteinase-2), and regulatory genes Ras Association Domain Family Member 1, Isoform A (RASSF1A), WAP Four-Disulfide Core Domain Protein 10A (WFDC10A), and Methyltransferase-Like Protein 7A (METTL7A) across multiple cancer cell lines, and evaluates the anticancer potential of repurposed mebendazole. METHODS: Eight human cell lines, including breast (MCF7 and MDAMB231), colorectal, pancreatic, lung, hepatocellular, leukemia, and endothelial models, were profiled by qRT-PCR and Western blotting. Expression was assessed under basal conditions and following mebendazole exposure (0.7 µM). RESULTS: Basal expression revealed elevated ENOX2 and MMP2 in aggressive cancers (MDA-MB-231, PANC1). Mebendazole significantly downregulated ENOX2 in HEPG2 (p < 0.01) and K562 (p < 0.05), and suppressed MMP2 in MDA-MB-231 (p < 0.05) and MCF7 (p < 0.01), indicating anti-invasive effects. Tumor suppressors were selectively induced: RASSF1A increased >200-fold in endothelial cells (p < 0.01) and was upregulated in HEPG2 and HT29 (p < 0.05), while WFDC10A was strongly elevated in MDA-MB-231 (>40-fold, p < 0.001). METTL7A displayed endothelial enrichment with heterogeneous tumor-specific regulation. Collectively, these findings reveal cell-type-specific modulation of oncogenic and suppressor pathways. CONCLUSION: This multi-cancer investigation identifies ENOX2-MMP2 signaling as a functional driver of invasion and metastasis and demonstrates that mebendazole reprograms oncogenic-tumor suppressor networks. By integrating biomarker profiling with drug repurposing, our study highlights the translational potential of mebendazole as a cost-effective anticancer agent and supports the development of multi-gene biomarkers for diagnosis and therapy in aggressive malignancies.