Efficacy of Metformin as Adjuvant Therapy in Metastatic Breast Cancer Treatment

Abstract

Background: Metformin has been reported to have an anti-tumorigenic impact against metastatic breast cancer (MBC) cells through several mechanisms. Its effect can be evaluated by using many variables such as the response rate (RR) as well as the progression-free survival (PFS). Materials and methods: A prospective study was conducted to investigate and estimate the metformin effect on MBC. About 107 subjects were included in the study and were divided into two groups: Group A included non-diabetic MBC patients treated with metformin in conjunction with chemotherapy and group B included those treated with chemotherapy alone. Both PFS and RR were used as a criteria to evaluate the treatment outcome. Associated adverse effects of metformin were also assessed. Results: The average age of the participants in group A and group B was 50 vs. 47.5, respectively. No significant differences were detected between both cohorts concerning RR levels (regression disease (RD) 27.8% vs 12.5%, stationary disease (SD) 44.4% vs 41.7%, progression disease (PD) 27.8% vs 45.8%, respectively, p = 0.074). Moreover, PFS showed no significant difference between both groups (p = 0.753). There was no significant correlation between metformin concentration and their adverse effects on the study participants. Conclusion: Metformin as an adjuvant therapy to MBC undergoing chemotherapy showed no significant survival benefit as determined by RR and PFS.

The Effect of SGLT2i on the GH/IGF1 Axis in Newly Diagnosed Male T2D Patients - A Prospective, Randomized Case-Control Study

“…There was a trend of improvement in HOMA-IR [4.57 (3.69, 8.43), 4.3792.82, 6.45), P = 0.24] and HOMA-β [34.21 (15.91, 51.21), 44.71 (25.54, 83.09), P = 0.18], but there was no signi cant statistical change, which may be related to the short intervention time. Metformin treatment had no effect on GH, IGF1, and IGFBP3, which is consistent with the literature report [24] After 12 weeks of treatment with Metformine + SGLT2i, patients' diabetes statuses were noticeably improved, including in levels of FPG, HBA1c, HOMA-IR, HOMA-β, and UACR. Moreover, Metformine + SGLT2i treatment increased blood levels of IGF1 and the IGF1/IGFBP3 ratio, but had no effect on blood GH and IGFBP3 levels.…”

Efficacy of metformin in prevention of paclitaxel-induced peripheral neuropathy in breast cancer patients: a randomized controlled trial

“…However, it did remain tolerable in respect to the self-resolved adverse effects, and none of the patients required treatment discontinuation. Similar findings have been reported with the adjuvant use of metformin in efficacy investigating studies ( Barakat et al, 2022 ; Essa et al, 2022 ). The incidence of gastrointestinal complications is generally more frequent with metformin immediate-release preparations than with extended-release ones.…”

Ianus Bifrons: The Two Faces of Metformin

“…In the phase III, double-blind and placebo-controlled RCT conducted in 3649 non-diabetic patients with BC, the addition of metformin to standard adjuvant therapy did not lead to a significant improvement in invasive disease-free survival [143]. Similarly, no significant survival benefits were detected in terms of PFS or response rate (RR) related to the combination of biguanide and chemotherapy in a study involving 107 non-diabetic patients with metastatic BC [144]. However, slightly higher OS and PFS, but with no statistical significance, were associated with metformin and adjuvant chemotherapy in the phase II trial of Salah.…”