SATURDAY, March 31 (HealthDay News) -- A diabetes medication
used by millions is now showing promise against a variety of
different cancers.
Two new clinical studies to be presented Saturday at the annual
meeting of the American Association for Cancer Research, in
Chicago, found that metformin (also known by the brand name
Glucophage, among others), appeared linked to a slowing in the rate
of prostate cancer growth in certain patients, and in prolonging
life for early-stage pancreatic cancer patients.
Other studies, done either in the lab or in animals, also hint
that the drug might have an effect against liver or oral tumors, as
well as certain forms of melanoma.
The findings have sparked interest in the cancer field and do
seem promising, but much more research needs to be done before the
drug can be recommended as a cancer treatment, experts said.
"There are very exciting clues from laboratory studies and population studies that metformin . . . may improve cancer outcomes or lower cancer risk," said Dr. Michael Pollak, professor of oncology and of medicine at McGill University in Montreal. "However, we need more laboratory and clinical studies to find the best dose to use, to understand in what disease situations it may help most, and also to determine if metformin itself or a metformin derivative would be most suitable for trials."
Metformin has also shown promise against colon and breast
cancer, noted Pollak, who is a co-author on the prostate cancer
trial.
For that trial, 22 men with prostate cancer received 500
milligrams of metformin three times a day after their diagnosis but
before they were scheduled to undergo removal of the prostate
gland, a procedure known as prostatectomy.
After an average treatment time of 41 days, men taking metformin
showed a slowing in the growth of cancer cells in the prostate
after it had been removed versus in the earlier biopsy samples,
said study lead author Dr. Anthony Joshua, a staff medical
oncologist with Princess Margaret Hospital/University Health
Network in Toronto.
Not surprisingly, metformin also decreased blood sugar levels,
insulin growth factor and body mass index (BMI, a measure of
obesity).
None of the men in the study had diabetes, said Joshua, so "it
remains to be seen who would benefit the most from metformin." The
most appropriate patients may be those with diabetes, those who are
at risk for the disease or those whose tumors are sensitive to
metformin.
It's unclear exactly how metformin exerts its effect but it may
reduce the amount of circulating insulin in the blood, and insulin
can fuel the growth of prostate cancer cells, explained Joshua.
The drug may also interfere with a specific pathway linked to
cancer growth, he added.
The results build on prior research done in the laboratory but
are the first to be seen in humans. Experts note, however, that
research presented at medical meetings is typically considered
preliminary until published in peer-reviewed journals.
In another study, researchers at the University of Texas M.D.
Anderson Cancer Center in Houston, reviewed records of 302 patients
who had both diabetes and pancreatic cancer, two conditions that
often go hand-in-hand. A total of 117 patients were taking
metformin.
About 30 percent of those who had taken the drug were alive
after two years, compared with 15.4 percent of those who had not
taken metformin (the "control" group).
And patients on metformin lived an average of just over 15
months versus about 11 months for the control group, translating
into a 32 percent reduced risk of dying.
But the survival benefit was seen only in patients whose cancer
had not yet spread. The study was published in the journal
Clinical Cancer Research.
"I think it's very hopeful," said Dr. Michael Pishvaian, assistant professor of hematology/oncology at Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C. "Metformin may help keep blood sugar levels down [which improves prognosis for cancer patients] but it may also work in a number of different ways to combat cancer cell growth."
The next step is to test the concept in a prospective fashion,
said Pishvaian, who was not involved with the study.
Three other studies, also released Saturday, suggest that
metformin might be active against other cancer types:
- Researchers at the University of Maryland School of Medicine
report that metformin appeared to slow the growth of liver tumors
in mice.
- A team at the U.S. National Institute of Dental and
Craniofacial Research said that, in mouse studies, metformin
appears to reduce the number and size of oral cancer lesions.
- Research conducted at the Paterson Institute for Cancer
Research in Manchester, England, finds that combining metformin
with certain cancer drugs worked better to suppress a certain type
of melanoma versus using the cancer drugs alone.
The liver cancer and oral cancer studies were published March 31
in
Cancer Prevention Research, while the melanoma study appears in the March 31 issue of Cancer Discovery.
More information
The
U.S. National Cancer Institute has more on
prostate cancer.