Efficacy of Metformin as Adjuvant Therapy in Metastatic Breast Cancer Treatment

Nourhan M Essa, Heba F Salem, Marwa O Elgendy, A Gabr, Mervat M Omran, Nivin A Hassan, Hanaa M Tashkandi, Steve Harakeh, Marian S Boshra, Nourhan M Essa, Heba F Salem, Marwa O Elgendy, A Gabr, Mervat M Omran, Nivin A Hassan, Hanaa M Tashkandi, Steve Harakeh, Marian S Boshra

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.

Keywords: metastatic breast cancer (MBC); metformin; non-diabetic patients.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Molecular structure of metformin.
Figure 2
Figure 2
Chromatogram for detection of metformin standard with concentration 1.5 ug/mL.
Figure 3
Figure 3
Calibration curve for metformin on concentration range (0.3–50 ug/mL). In the equation: x^2 = x2 and e= 103.
Figure 4
Figure 4
Kaplan–Meier curves for response rate among both studied groups.
Figure 5
Figure 5
Kaplan–Meier curves for progression free survival among both studied groups.

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