- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04170465
Role of Adding Metformin to Neoadjuvant Chemotherapy in Patients With Breast Cancer (METNEO) (METNEO)
Investigation of the Potential Beneficial Effect of Adding Metformin to Neoadjuvant Chemotherapy in Patients With Breast Cancer (METNEO)
Metformin, the widely prescribed oral hypoglycemic drug, is well known for its established efficacy, favorable safety profile, and low cost. Metformin has recently received increasing attention because of its potential antitumorigenic effects that are thought to be independent of its hypoglycemic effects. It has been extensively studied in preclinical models, which have implicated several molecular pathways in its antitumor activity.
Metformin was proved to have anti-proliferative and apoptotic effects on tumor cells.Moreover, metformin enhances the T-cell mediated immune response to tumor tissue and fights metastases. Also, epidemiological studies have shown that metformin, but not other antidiabetic drugs, reduces cancer incidence and improves survivability in diabetic cancer patients.
The proposed research in this application will investigate two prime questions with regards to the combined use of metformin together with traditional neoadjuvant chemotherapy in breast cancer patients. First, the hypothesis that the simultaneous use of metformin along with doxorubicin/cyclophosphamide/paclitaxel neoadjuvant protocol produces better antitumor outcomes will be tested. Second, the study will examine if the improved apoptotic effect of such regimen is paralleled by exaggerated stimulatory influences on apoptosis biomarkers.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
- Ethical committee approval will be obtained from Ethics committee of Faculty of Pharmacy, Damanhour University.
- All participants should agree to take part in this clinical study and will provide informed consent.
- Sixty female breast cancer patients, who are candidates for neoadjuvant chemotherapy, will be recruited from the Medical Research Institute, Oncology department, Alexandria University, Alexandria.
The 60 participants will be randomly assigned into 2 arms:
- Control arm (n=30): will be treated with AC-Taxol regimen (AC: Doxorubicin 60 mg/m2 IV + cyclophosphamide 600 mg/m2 IV) for 4 cycles every 3 weeks. Subsequent Taxol cycles (Paclitaxel 80mg/m2 IV) once weekly for 12 weeks.
- Metformin arm (n=30): will be treated with the AC-Taxol regimen mentioned above together with Metformin 850 mg tablets orally twice per day (1700 mg/day).
All patients will be submitted to:
- Full patient history and clinical examination.
- Routine follow up before each chemotherapy cycle (complete blood picture, liver function tests, renal function tests).
- Routine Echocardiography before each chemotherapy cycle.
- All patients will be monitored for the incidence of chemotherapy toxicities during neoadjuvant therapy.
- After completion of the neoadjuvant therapy, participants will undergo surgical tumor removal. The excised tumor will be collected, and the expression of apoptosis biomarkers and the pathologic complete response (pCR) will be assessed.
- Patients demographic data will be recorded with respect to age, weight and disease history.
- Statistical tests appropriate to the study design will be conducted to evaluate the significance of the results.
- Results, conclusion, discussion and recommendations will be given.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Beheira, Egypt, 22511
- Damanhour University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Females ≥ 18 years of age and < 65 years.
- Unilateral or bilateral primary carcinoma of the breast confirmed.
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-2.
- Clinically measurable tumor size who are candidates for neoadjuvant therapy.
- No evidence of distant metastasis.
- Normal renal and liver functions.
- Non-diabetics.
Exclusion Criteria:
- Pregnant or breastfeeding women.
- Prior cancer chemotherapy.
- Heart disease or reduced cardiac output with left ventricular ejection fraction < 50%.
- Metastatic breast cancer patients.
- Patients with hepatic impairment.
- Patients with renal impairment.
- Diabetics.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Metformin group
Patients will receive AC-T neoadjuvant chemotherapy in addition to oral metformin HCl (850 mg tablets, twice per day, for 6 months) (n= 30)
|
Oral administration of Metformin hydrochloride 850 mg tablets (1700 mg/day) daily until the completion of neoadjuvant chemotherapy cycles
Other Names:
AC: (Doxorubicin 60 mg/m2 IV + cyclophosphamide 600 mg/m2 IV) for 4 cycles every 3 weeks followed by Taxol cycles (Paclitaxel 80 mg/m2 IV) once weekly for 12 weeks.
Other Names:
|
ACTIVE_COMPARATOR: Control group
Patients will receive AC-T neoadjuvant chemotherapy alone (n= 30)
|
AC: (Doxorubicin 60 mg/m2 IV + cyclophosphamide 600 mg/m2 IV) for 4 cycles every 3 weeks followed by Taxol cycles (Paclitaxel 80 mg/m2 IV) once weekly for 12 weeks.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of the effect on tumor apoptosis
Time Frame: 6 months
|
Tissue level of the apoptosis biomarker in the excised tumor.
|
6 months
|
Chemotherapy toxicities
Time Frame: 6 months
|
Monitoring the incidence of chemotherapy toxicities during neoadjuvant therapy
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pathologic complete response rate (pCR)
Time Frame: 6 months
|
Pathologic complete response rate defined as the absence of residual invasive cancer in the resected breast specimen and all sampled regional lymph nodes following completion of neoadjuvant systemic therapy.
|
6 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Mahmoud M El-Mas, PhD, Professor in Pharmacology, Faculty of Pharmacy, Alexandria University
- Study Director: Yasser M El-Kerm, PhD, Professor in Clinical Oncology, Medical Research Institute,Alexandria University
- Study Chair: Maged W Helmy, PhD, Professor in Pharmacology, Faculty of pharmacy, Damanhour University
- Study Chair: Amira B Kassem, PhD, Lecturer in Clinical Pharmacy, Faculty of Pharmacy, Damanhour University
- Study Chair: Noha A El-Bassiouny, PhD, Lecturer in Clinical Pharmacy, Faculty of Pharmacy, Damanhour University
- Principal Investigator: Manar A Serageldin, Bachelor, Teaching assistant in Pharmacology, Faculty of Pharmacy, Alexandria University
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Neoplasms
- Neoplasms by Site
- Breast Diseases
- Breast Neoplasms
- Hypoglycemic Agents
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antirheumatic Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Antineoplastic Agents, Phytogenic
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Antibiotics, Antineoplastic
- Cyclophosphamide
- Paclitaxel
- Metformin
- Doxorubicin
Other Study ID Numbers
- 919PP18
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Breast Cancer Female
-
Institut fuer FrauengesundheitNovartis Pharmaceuticals; AGO Breast Study Group e.V.RecruitingBreast Cancer | Breast Neoplasms | Advanced Breast Cancer | Breast Neoplasm Female | Breast Cancer Female | HER2-negative Breast Cancer | Hormone Receptor-positive Breast CancerGermany
-
H. Lee Moffitt Cancer Center and Research InstituteNovartisCompletedBreast Cancer | Breast Cancer - Female | Breast Cancer - MaleUnited States
-
Quanta MedicalLattice MedicalRecruitingBreast Reconstruction | Breast Cancer Female | Breast Cancer PreventGeorgia, France
-
Masaryk UniversityMasaryk Memorial Cancer InstituteRecruitingBreast Cancer Stage I | Breast Cancer Stage II | Breast Cancer Female | Breast Cancer Stage IIICzechia
-
University of ChicagoRecruitingBreast Cancer | HER2-positive Breast Cancer | Breast Cancer Stage II | Breast Cancer Female | Breast Cancer Stage IIINigeria
-
Ahon Pharmaceutical Co., Ltd.RecruitingAdvanced Breast Cancer | Female Breast CancerChina
-
Ahon Pharmaceutical Co., Ltd.RecruitingAdvanced Breast Cancer | Female Breast CancerChina
-
Institut fuer FrauengesundheitSamsung Bioepis Co., Ltd.RecruitingBreast Cancer | Breast Neoplasms | HER2-positive Breast Cancer | Breast Cancer FemaleGermany
-
Wake Forest University Health SciencesAtrium Health NavicentActive, not recruitingBreast Cancer Female | Early-stage Breast CancerUnited States
-
Institut fuer FrauengesundheitEisai GmbHRecruitingAssessing ImmunoResponse Post Eribulin: Eribulin and Immunogenicity in Advanced Breast Cancer (AIRE)Breast Cancer Female | Breast Cancer Metastatic | Neoplasm, BreastGermany
Clinical Trials on Metformin Hydrochloride 850 mg Tablets
-
Teva Pharmaceuticals USACompleted
-
Hospital Civil de GuadalajaraUnknown
-
Boehringer IngelheimEli Lilly and CompanyCompleted
-
University Hospital, AntwerpHasselt University; University Hospital, Ghent; AZ Sint-Jan AV; National MS Center... and other collaboratorsRecruitingMultiple Sclerosis | Primary Progressive Multiple Sclerosis | Secondary-progressive Multiple SclerosisBelgium
-
Rajavithi HospitalCompletedMetformin | CA EndometriumThailand
-
Reseach Laboratory of Clinical and Experimental...Société Arabe des Industries Pharmaceutiques SAIPH - Tunisia; Centre National...CompletedFed ConditionsTunisia
-
Mylan Pharmaceuticals IncCompleted
-
Mylan Pharmaceuticals IncCompleted
-
Mylan Pharmaceuticals IncCompleted
-
Teva Pharmaceuticals USACompleted