Metformin Shows Preliminary Promise Against Prostate, Pancreatic Tumors
By Charlene Laino
WebMD Health News
By Laura J. Martin, MD
April 3, 2012 (Chicago) -- The diabetes drug metformin -- commonly a first choice for controlling blood sugar in people with type 2 diabetes -- is sparking new interest as a cancer fighter.
A new study presented here at the American Association for Cancer Research (AACR) annual meeting shows that metformin (Fortamet, Glucophage, Glumetza, Riomet) may put the brakes on the growth of tumor cells in men with prostate cancer. Another study released in one of the association's journals suggests that it may extend the lives of people with pancreatic cancer.
But experts caution that the work is still preliminary and more study is needed before metformin can be recommended as a cancer treatment.
"These are still the early days," says Jose Baselga, MD, PhD, chief of hematology/oncology at Massachusetts General Hospital. "But there are strong signals of an anti-cancer effect."
Metformin vs. Prostate Cancer
One new study involved 22 men with prostate cancer. They took metformin pills three times a day from the time they got their diagnosis to when they had their prostates removed, an average period of 41 days.
Researchers compared tissue from biopsies taken at diagnosis to tissue removed at the time of surgery and found that metformin slowed the growth of tumor cells by 32%.
Levels of insulin-like proteins in the blood also dropped.
Still unknown is whether men who take metformin are more likely to beat prostate cancer, says researcher Anthony M. Joshua, MBBS, PhD, a staff medical oncologist at Princess Margaret Hospital/University Health Network in Toronto.
But a growing body of evidence -- from lab, animal, and human studies -- suggests metformin mounts a multi-pronged attack against cancer, he tells WebMD. It lowers levels of insulin in the blood, and insulin contributes to the growth of cancer cells, Joshua says.
Metformin also shuts down the so-called mTOR pathway, which "is the cellular motor that makes cancer cells grow," he says. And it may slow down the metabolism of cancer cells, causing them to die off, Joshua says.
None of the men in the study had diabetes, so it is conceivable that men with diabetes and men without the condition both may benefit from metformin's cancer-fighting effects, he says.
None of the men experienced serious side effects from the drug in the study. Diarrhea, nausea, and gas are common side effects associated with its use in diabetes.
"It's very early and the study is small," says Nancy Dawson, MD, a prostate cancer specialist at Georgetown Lombardi Comprehensive Cancer Center. "But's it's fascinating to see such a slowing of cancer cell growth in such a short period of time."
Phillip Dennis, MD, PhD, of the National Cancer Institute, says, "The data suggest that if metformin is working, it is [attacking cancer cells in ways] that have not been identified. People should not start taking metformin for prostate cancer," he tells WebMD.
There will be about 240,000 new cases of prostate cancer in 2012, according to the American Cancer Society. About 13 million, or 11.8% of all men aged 20 years or older, have diabetes, according to the American Diabetes Association.
Metformin vs. Pancreatic Cancer
Researchers at the University of Texas M.D. Anderson Cancer Center in Houston examined the records of 302 people with pancreatic cancer and diabetes; 117 were taking metformin.
Results showed that 30% of those taking metformin were alive at two years vs. 15% of those who weren't taking the diabetes drug.
Also, people on metformin lived an average of 15 months vs. 11 months for those who didn't take the drug.
The study doesn't prove that metformin made the difference. People who took the drug might have other advantages that weren't measured.
More study of metformin in these and other cancers is planned. If it does pan out, one plus could be price. While new cancer drugs can cost thousands of dollars a dose, a month's supply of metformin is typically $30 to $50.
These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
American Association for Cancer Research Meeting 2012, Chicago, March 31-April 4, 2012.
Jose Baselga, MD, PhD, chief, hematology/oncology, Massachusetts General Hospital, Boston.
Anthony M. Joshua, MBBS, PhD, staff medical oncologist, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
Clinical Cancer Research.
Nancy Dawson, MD, professor of medicine, Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C.
Phillip Dennis, MD, PhD, head, signal transduction section, medical oncology branch, National Cancer Institute, Bethesda, Md.
Li, D. Clinical Cancer Research, published online March 31, 2012.
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