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Metformin-Anyone on this trial?

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  • HLB
    HLB Member Posts: 740
    edited April 2015
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    Thanks John Smith. I am very encouraged by all of the studies showing promise with this drug. I just hope it works for humans too! I wonder if I should be taking my vit D at the same time.

  • starella
    starella Member Posts: 101
    edited April 2015
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    hello, has anyone heard or read how long we can take metformin if we don't have diabetes?

  • fluffqueen01
    fluffqueen01 Member Posts: 1,795
    edited April 2015
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    I've been taking it for three years, using the trial dose.

  • SlowDeepBreaths
    SlowDeepBreaths Member Posts: 6,702
    edited April 2015
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    Thanks for posting the study JohnSmith.

    sbelizabeth, I emailed the letter to my MO. I am definitely interested and would like to learn more about SE's.

  • JohnSmith
    JohnSmith Member Posts: 61
    edited May 2017
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    For those that are new to the forum, this thread was created in 2011. The motivation behind it is based on this Phase III Clinical Trial. (I'm not sure where the OP is at, but the link should have been added to the original post).

    Primary Link: A Phase III Randomized Trial of Metformin vs Placebo in Early Stage Breast Cancer
    Enrollment: 3649
    Study Start Date: July 2010
    Estimated Study Completion Date: December 2016
    Estimated Primary Completion Date: June 2017 (Final data collection date for primary outcome measure)

    The Trial "Completion" dates have been updated (as of July 2016). Below are the new dates:

    Enrollment: 3649
    Study Start Date: July 2010
    Estimated Study Completion Date: July 2020
    Estimated Primary Completion Date: January 2020
    (Final data collection date for primary outcome measure)


    Off topic, there's a different Phase III trial involving Metformin. It appears focused on "Stage 0" folks.

    Link: Metformin Hydrochloride in Patients With Atypical Hyperplasia or In Situ Breast Cancer to Placebo in Decreasing Atypical Cells in Patients With Atypical Hyperplasia or in Situ Breast Cancer
    Estimated Enrollment: 400
    Study Start Date: August 2013
    Estimated Primary Completion Date: January 2017

  • Ddw79
    Ddw79 Member Posts: 217
    edited April 2015
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    I've been taking Metformin for years because I am a type 1 Diabetic. I just got diagnosed with ADH a high risk condition. I don't see how it has been of any help to me in combatting Breast Cancer. I take 1000 mgs daily going on three years now

  • PeggySull
    PeggySull Member Posts: 368
    edited April 2015
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    DDW79, I think that there are different factors with regard to getting BC and recurrence after BC treatment. I'm hoping that Metformin will help prevent recurrence. A friend who sometimes joins a monthly BC luncheon I attend was on Metformin for several years before she was dx'd with BC. So much is still unknown in breast and other cancers!

    Hugs to all, Peggy

  • ALHusband
    ALHusband Member Posts: 342
    edited May 2015
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    Ddw79 I read a study that says, strangely enough, Metformin is NOT effective in diabetics. http://www.medicinenet.com/script/main/art.asp?articlekey=169858 . As PeggySull says, so much is still unknown.

  • DianaNM
    DianaNM Member Posts: 62
    edited June 2015
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    I've been taking 500mg since my 2012 diagnosis based on the trials. Stopped about a month ago when I got a warning on my health insurance site. You aren't supposed to take Metformin if you have low blood oxygen. I do, thought I attribute it to living at a high altitude. I have been pre-diabetic in the past, so figured it was extra insurance too.

    Anyway, I haven't had a recurrence. But I was diagnosed today with a different cancer in my remaining breast. Don't know if Metformin is supposed to prevent ILC, but if so it didn't work.

  • mary625
    mary625 Member Posts: 154
    edited June 2015
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    Oh, Diana, so sorry to hear that! So you had IDC and now have ILC in the other breast?

  • JohnSmith
    JohnSmith Member Posts: 61
    edited January 2016
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    Here's another research study (Barts Cancer Institute in the UK) showing the power of Metformin against cancer. This new research exploits a discovery unique to Pancreatic stem cells.
    Researchers found that Metformin targeted the mitochondria (sorta the engine of a cell) of Pancreatic stem cells and killed them.

    Pancreatic cancer stem cells could be 'suffocated' by an anti-diabetic drug

    Tags: Dr Patricia Sancho, Cancer Cell Biology, Cancer Stem Cells, Cell Signalling, Resistance, Metabolism, oxidative phosphorylation (OXPHOS)

    From the lab of Dr. Sancho (Jan 2016): Cancer stem cells (CSCs) represent a subset of cancer cells that self-renew and are a source of the tumour cell bulk. These highly tumorigenic cells, when they survive treatment, can lead to tumour relapse and promote metastasis. Therefore cancer stem cells are a key target for any new treatment approach.

    Although still under intense investigation, it has been proposed that CSCs undergo metabolic reprogramming; acquiring distinct metabolic features compared to the tumour cells they produce. As a result, CSCs may be better adapted to the tumour microenvironment as they could make use of alternative sources of energy or become more efficient at getting energy from them. However, CSCs' distinct metabolic characteristics could also represent drug targets, opening new therapeutic avenues.

    We and others recently reported that the anti-diabetic compound and mitochondrial complex I inhibitor metformin significantly delays tumour growth in a pancreatic cancer model. We showed that this compound was particularly lethal to the CSC subpopulation, having anti-growth and cell death-promoting effects. We also reported that metformin was able to prevent nicotine-induced pancreatic carcinogenesis and tumour growth in a mouse model by promoting acinar cell formation.

    These findings suggest that metabolism-based strategies could be a powerful tool to combat pancreatic cancer, and could be expanded to other resilient tumour types.

  • mary625
    mary625 Member Posts: 154
    edited December 2015
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    Has there been any news from the Metformin trial? Is it still ongoing? Thanks.
  • marijen
    marijen Member Posts: 2,181
    edited December 2015
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    Don't forget Metformin has sides, check at drugs.com

  • JohnSmith
    JohnSmith Member Posts: 61
    edited December 2015
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    Here's a Metformin article published today by Newsweek, "The Diabetes Drug That Could Be an Anti-Aging Miracle"
    According to Dr. Nir Barzilai, a scientist at the Albert Einstein College in New York City, "Metformin has been found to stall the aging process in animal studies. It's an old, generic diabetes drug, known for being quite safe and it's dirt cheap - costs about 35 cents per pill".

    Yesterday at SABCS, Dr. Pamela Goodwin of Mount Sinai Hospital in Toronto Canada provided a lecture called: "Targeted Interventions: Metformin and Lifestyle Change" as part of the SABCS educational session on "Metabolic Syndrome and Obesity in Breast Cancer".
    There doesn't appear to be a link summarizing the discussion, yet.
    She is the Principal Investigator of the large, NCI funded, Phase III Metformin trial (NCT01101438), found here.
    However, patience is required since we are a couple years away from these trial results.

    In addition, there were a couple SABCS poster sessions presented about Metformin this past week, but they were Lab studies of Metfomin in mice.

  • pessa
    pessa Member Posts: 137
    edited December 2015
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    Thank you for this info

  • Smurfette26
    Smurfette26 Member Posts: 269
    edited December 2015
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    I just stumbled upon this thread.

    I have taken Metformin for 10+ years for Insulin Resistance.

    In October I had a mastectomy; Multifocal Invasive Lobular Carcinoma.

  • mary625
    mary625 Member Posts: 154
    edited December 2015
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    Marijen--thanks for the reminder about side effects. This is one reason that I'm trying to find out what's going on. I'm taking Metformin and tolerating it well, but I have done some extensive genetic testing through 23andme and LiveWello and learned that Metformin might be depleting my B12. I've got a cluster of genetic issues around B vitamins and methylation, so I'm trying to weigh the advantages and disadvantages.

    John Smith--thank you for pulling this research together. I do so hope there'll be a summary of Dr. Goodwin's lecture. I am exactly the focus--a patient with metabolic syndrome.

    Smurfette--your n of 1 survey shows us that this is not going to be the cure. I also had lobular and metabolic syndrome. I was not yet being treated for metabolic syndrome at the time of diagnosis except for blood pressure. Do you have any personal theories on why you got lobular?
  • PeggySull
    PeggySull Member Posts: 368
    edited December 2015
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    I am on metformin because of the numerous research studies showing it MAY reduce the recurrence rate for my tnbc, stage 2a. In the last 6 months the doctor who was prescribing it retired, and we moved to another part of the country. So rattled that I can't remember if I need blood test to check liver function at 3month or 6 month intervals.

    Can anyone on metformin for this purpose help me. I am living in a small town now and my maintenance onc isn't familiar with the blood testing protocol. While I am looking for another onc doc who is more knowledgeable , I would truly appreciate knowing about someone else's schedule.

    Thanks in advance,

    Peggy

  • leggo
    leggo Member Posts: 379
    edited December 2015
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    Hi Peggy. Every three months for me but I have kidney issues. I think six months is the norm. Oh, and after every CT scan in which tracer is used.

  • PeggySull
    PeggySull Member Posts: 368
    edited December 2015
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    Thanks leggo,

    It helps to know that the norm is every six months if no other complicating issues! Finances are really tight right now and my 3 month appt. Would put me right in the high deductible part of my medical insurance.

    Thanks for taking the time to reply!

    Peggy

  • JohnSmith
    JohnSmith Member Posts: 61
    edited January 2016
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    This Oct 2013 story, while old, is interesting on numerous level. I'm posting it due to a comment made by Jim Watson about Metformin.
    Jim Watson, awarded the Nobel Prize during the 1960's for helping to discover the structure of DNA, thinks the Oncology industry is headed in the wrong direction. Despite leading the Human Genome Project as its first director, he questions whether genetic approaches to treating cancer can ever lead to the breakthroughs we need. He basically says targeted therapies eventually lead to resistance and are a waste of time. He believes that research into the cancer metabolomics (like the Warburg effect) are a better approach.

    Full article, called "Jim Watson: DNA revealed the causes, it may never reveal a cure" is here.

    Here's an except from the article where he discusses Metformin:

    For the past few years, Watson has been turning his attention to things that all cancer cells have in common, however advanced the stage, no matter how chaotic and mutated the cancer cell, with a particular focus on the cancers that are the most resistant to treatment. So rather than looking for ways to inhibit the 'always on' signals that typically trigger particular cancers (HER2, RAS, RAF, MEK, ERK PI3K, AKT, mTOR and the rest), he is searching for weaknesses in the key regulatory and metabolic features that are common to all 'always on' cancer cells. He argues that we should focus far more on the wide range of metabolic and oxidative vulnerabilities that arise as a consequence of the uncontrolled growth and proliferation capacities of cancer cells.

    Metformin, the type 2 diabetes treatment, offers some vital clues, he says. Known to protect against a wide variety of cancers, and to selectively kill cancer stem cells (which are normally highly resistant), it is now in trials to see whether it can augment response to cancer treatment. Watson is not confident the results will be positive, but is convinced something significant is going on which needs to be better understood. Metformin is Watson's kind of drug - it seems to work better in cancers that are hardest to treat.

    Watson says, "A really intriguing thing about metformin is that it kills triple-negative breast cancer much better than say lobular breast cancer. So it kills the nastiest cancers, it doesn't kill the others."
    [ Did you Lobular patients read that statement? It might be worth investigating this notion.]
    It turns out, he says, that metformin kills cancer cells that have lost both copies of the powerful p53 tumour suppressor gene much better than those with both p53 genes intact. "Even though normally p53 promotes apoptosis and that ability has been taken away, it still kills tumour cells." This gives Watson reason to believe that the drug may prove to be more active against late-stage cancers where cells are so mutated that most will have lost both their p53 genes.

  • sas-schatzi
    sas-schatzi Member Posts: 15,879
    edited January 2016
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    John have you read any of these articles? I copied them to a post on my weight thread. Since you have studied this more than moi, How do these plug in?

    "This link is to a history of Metformin. At the bottom, they're links to the resource articles. I read them all. Easy recreational reading. What science proved about the chemical that came to be eventually identified as Glucophage?Metformin in 1957 has a pretty amazing history. It's a perennial. Used particularly in the Middle Ages, but documented much farther back than that.

    http://www.news-medical.net/health/Metformin-History.aspx

    What surprises me after reading it's history is that Metformin is not used in the overweight non diabetic. There were two early studies that clearly showed that a nondiabetic experiences only none to mild reduction in glucose while the diabetic(type2) experiences a significant reduction.The study in the PCOS group showed that those with more centrally located adipose tissue had a weight loss where those that didn't have central fat didn't. Sounds to me like a study. Too lazy right now to go and see if that's an existing finding already. I know the weight loss is a known effect of Glucophage, but not if the identification of the central fat loss is known. Maybe someone will pop in a say YEAH that's been known for years LOL.

    I'll volunteer for the study. i.e. nondiabetic with central fat

    Thought I'd bring these links here. They were at the bottom of the above article and identified as the source for that article.


    1. http://www.jci.org/articles/view/14178
    2. http://onlinelibrary.wiley.com/doi/10.1002/pdi.606/pdf
    3. http://www.rsc.org/images/eic_nov2011_metformin_tcm18-210010.pdf
    4. http://media.wiley.com/product_data/excerpt/19/04707254/0470725419.pdf
    5. http://www.ncbi.nlm.nih.gov/pubmed/9742976
    6. Bailey CJ, Campbell IW, Chan JCN, Davidson JA, Howlett HCS, Ritz P. Metformin - The Gold Standard: A Scientific Handbook. Chichester: Wiley, 2008; 1-36.
  • jojo68
    jojo68 Member Posts: 336
    edited February 2016
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    Okay...Im confused about the Lobular not being helped much by metformin....but helps late stage cancers. I am lobular AND late stage....so, should I continue on my Metformin?

  • JohnSmith
    JohnSmith Member Posts: 61
    edited February 2016
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    jojo... I wouldn't make treatment decisions based on anything written here, unless its supported by your medical team. In other words, don't stop Metformin because of this guys opinion. I wrote it to get others to ask these questions during MO appointments. (It's one of many questions I have for our MO, who we don't see until April.)

    I haven't been able to track down an email address for Jim Watson to discuss his statement. He's pushing 90, so it's unlikely I'll ever connect with him.

    Also, here's new study results about Metformin, released Feb 24th: Immune-mediated antitumor effect by type 2 diabetes drug, metformin. Combined use of metformin and cancer vaccine improved CD8+ TIL multifunctionality.

  • JohnSmith
    JohnSmith Member Posts: 61
    edited February 2017
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    New Metformin research.

    Accumulating evidence suggest that the Tumor Microenvironment (TME) regulates cancer cells, contributing to progression and metastasis. Not good. The TME contains a mixture of cells, some good, some bad. Some of these cells are immune cells called Macrophages. Macrophages are good immune cells but cancer corrupts them and converts some Macrophages to the dark side (think Darth Vader). These are referred as Tumor-associated Macrophages or TAMs. These TAMs are bad and prevent cancer therapies from working. Not good.
    However, recent pre-clinical research has revealed that the diabetes drug Metformin can exert an anti-tumor effect through TAMs. This is good.
    Interested in learning more?
    Here's the full study: https://www.researchgate.net/publication/313320034_Metformin-treated_cancer_cells_modulate_macrophage_polarization_through_AMPK-NF-kB_signaling

    *****

    As a reminder, this thread was established in 2011. The original poster failed to add the links to the Phase III metformin Clinical Trial.

    A Phase III Randomized Trial of Metformin vs Placebo in Early-Stage Breast Cancer
    Trial Link: https://clinicaltrials.gov/ct2/show/NCT01101438
    Enrollment: 3649
    Study Start Date: July 2010
    Estimated Primary Completion Date: December 2019 (Final data collection date for primary outcome measure)

  • purple32
    purple32 Member Posts: 1,767
    edited March 2017
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    "My oncologist would not prescribe Metformin until the results of the large clinical trial come out in 2016..."

    Well?
    What are the reslts ? Anybody know ? I've been out of the loop- sorry.

  • wallycat
    wallycat Member Posts: 1,278
    edited March 2017
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    They are in phase III and no results till 2020

    https://clinicaltrials.gov/ct2/show/results/NCT011...


  • slv58
    slv58 Member Posts: 486
    edited March 2017
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    I keep asking my MO and I get the standard reply that it doesn't look encouraging. Now that she's on mat leave I asked the MO taking over and she said that results were in that it does not help with TN and they stopped the trial for TN! I don't get that impression at all on these boards. Wondering if this is a runaround

  • purple32
    purple32 Member Posts: 1,767
    edited March 2017
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    Wow1
    Everything takes so long. I had an endo dr who gave it to me once as my numbers were close to pre diabetic, but I had bad SE's and at that time, there was no evidence at all... just wondering.

  • chemicalworld
    chemicalworld Member Posts: 48
    edited March 2017
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    Hi to all. I am NOT taking part in a clinical trial, however was approached to do so back in 2011 when I finished my active treatment and chose not to participate at that time. Having a history of PCOS, I asked my then gyno about it and I guess based mostly on that, was given a prescription and have been taking 1500mgs since late 2011. I am not diabetic but there is a family history, and I think most women start on metformin because they are trying to regulate periods or conceive, which I am not trying to do either, thanks to chemopause and Lupron.

    I did ok I suppose with the drug, but over time, it negatively affected my B12 and I have had ongoing digestive issues (possibly compounded by Lupron?). Anyway, so today, when I saw my MO I asked about the studies, whether I needed to be on such a high dose, or at all.

    He checked in with the trial going on in my area, and told me that they took all the Triple Negatives off the drug, as there were no known benefits. He said there were "some" benefits (unspecified, don't know what the benefits were) for ER+, which I am, but that they were basing it on needing to be on the drug for 5 years only.

    He told me that as I'd been on the drug for 5 years, I didn't need to be on it and could go off the drug if I wanted to. Of course now I'm wary of doing that.