Metformin and Chemotherapy - Synergy?

[pjoshea13]

New Chinese review below.

Seems that Metformin may have synergy with chemo for a good number of cancers.  PCa is mentioned.

"In this review, we summarized the molecular mechanisms underlying anticancer effects of metformin, which included insulin- and AMPK-dependent effects, selectively targeting cancer stem cells, reversing multidrug resistance, inhibition of the tumor metastasis and described the antineoplastic effects of metformin combined with chemotherapeutic agents in digestive system cancers (colorectal, gastric, hepatic and pancreatic cancer), reproductive system cancers (ovarian and endometrial cancer), prostate cancer, breast cancer, lung cancer, etc."

Difficult to pick out the properties that relate particularly to chemo.  i.e., while the benefits listed might be additive, which would enhance the effects of chemo?  Inhibition of drug resistance would be the obvious big benefit.

PCa Clinical Trials?

1]  "Metformin With Standard Taxotere and Prednisone" for CRPC.

"No accrual in initial period, PI decided to close study."

clinicaltrials.gov/ct2/show...

2]  "Metformin-Docetaxel" for CRPC.

"This study is currently recruiting participants."

clinicaltrials.gov/ct2/show...

{Taxotere = Docetaxel}

I imagine that accrual would be difficult since a CRPC patient should find it easy to get Metformin - so why risk being in the placebo arm.?  ADT induces the metabolic syndrome & fasting glucose would tend to be high enough to qualify for a Metformin prescription.

-Patrick

ncbi.nlm.nih.gov/pubmed/271...

Cancer Chemother Pharmacol. 2016 Apr 27. [Epub ahead of print]

Combinational strategies of metformin and chemotherapy in cancers.

Zhang HH1, Guo XL2.

Author information

1Department of Pharmacology, School of Pharmaceutical Sciences, Shandong University, No. 44 Wen Hua Xi Road, Jinan, 250012, People's Republic of China.

2Department of Pharmacology, School of Pharmaceutical Sciences, Shandong University, No. 44 Wen Hua Xi Road, Jinan, 250012, People's Republic of China. [e-mail].

Abstract

Chemotherapeutic regimens are the most common treatment to inhibit tumor growth, but there is great variability in clinical responses of cancer patients; cancer cells often develop resistance to chemotherapeutics which results in tumor recurrence and further progression. Metformin, an extensively prescribed and well-tolerated first-line therapeutic drug for type 2 diabetes mellitus, has recently been identified as a potential and attractive anticancer adjuvant drug combined with chemotherapeutic drugs to improve treatment efficacy and lower doses. In this review, we summarized the molecular mechanisms underlying anticancer effects of metformin, which included insulin- and AMPK-dependent effects, selectively targeting cancer stem cells, reversing multidrug resistance, inhibition of the tumor metastasis and described the antineoplastic effects of metformin combined with chemotherapeutic agents in digestive system cancers (colorectal, gastric, hepatic and pancreatic cancer), reproductive system cancers (ovarian and endometrial cancer), prostate cancer, breast cancer, lung cancer, etc. Moreover, the clinical trials regarding metformin in combination of chemotherapeutic drugs were presented and the clinical obstacle or limitation related to the potential role of metformin in cancer treatment was also discussed in this review.

KEYWORDS:

Cancer; Chemotherapeutic agents; Combination therapy; Metformin

PMID: 27118574 [PubMed - as supplied by publisher]

[Dan59]

Patrick,

     Thanks, and wow, I am so glad we have you finding out the latest information on recent trials and what works. I do know there was a study that came out in asco 2015 showing that metformin and a statin increases time to hormone resistance , many of the experts are using it now, It will be 10 years before the general Oncologist get the word IMO. When I found out I had my expert initiate metformin and was able to get a statin from local general Dr. on slightly elevated ldl.

Dan

[paulofaus]

This came in my newsfeed today..."This study indicates that metformin may not be an effective chemosensitizer for metastatic castration-resistant prostate cancer," the authors write."..doctorslounge.com/index.php....