Evaluation of metformin in early breast cancer: a modification of the traditional paradigm for clinical testing of anti-cancer agents
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Metformin, an inexpensive oral agent commonly used to treat type 2 diabetes, has been garnering increasing attention as a potential anti-cancer agent. Preclinical, epidemiologic, and clinical evidences suggest that metformin may reduce overall cancer risk and mortality, with specific effects in breast cancer. The extensive clinical experience with metformin, coupled with its known (and modest) toxicity, has allowed the traditional process of drug evaluation to be shortened. We review the rationale for a modified approach to evaluation and outline the key steps that will optimize development of this agent in breast cancer, including discussion of a Phase III adjuvant trial (NCIC MA.32) that has recently been initiated.
KeywordsBreast cancer Metformin Adjuvant Clinical testing
- 12.Pollak MN, Chapman JW, Shepherd L, Meng D, Richardson P, Wilson C et al (2006) Insulin resistance, estimated by serum C-peptide level, is associated with reduced event-free survival for postmenopausal women in NCIC CTG MA.14 adjuvant breast cancer trial. J Clin Oncol 24(Suppl 18S):(Abstr 524)Google Scholar
- 14.Goodwin PJ, Pritchard KI, Ennis M, Koo J, Hood N (2009) Long-term effects of fasting insulin in early stage breast cancer patients. Eur J Cancer Suppl 7:308 (abstr P-5160)Google Scholar
- 28.Vazquez-Martin A, Oliveras-Ferraros C, del Barco S, Martin-Castillo B, Menendez JA (2009) The antidiabetic drug metformin: a pharmaceutical AMPK activator to overcome breast cancer resistance to HER2 inhibitors while decreasing risk of cardiomyopathy. Ann Oncol 20:592–595CrossRefPubMedGoogle Scholar