The unexpected potential of metformin, a common diabetes drug, in combating cancer has intrigued researchers, but actual results remain mixed.
At a Glance
- Metformin, a drug used for diabetes, was tested for cancer treatment but did not show positive outcomes in clinical studies.
- Oncologist Pamela Goodwin advises against using metformin for breast cancer due to insufficient evidence supporting its effectiveness.
- Initial promising results were marred by issues like “immortal time bias” in studies.
- Some researchers suggest that metformin might benefit specific cancer subgroups or other health conditions.
The Journey from Diabetes to Cancer Research
Metformin, derived from French lilac, has been a leading treatment for diabetes since 1994. Its potential anticancer properties triggered a wave of research, delving into how it might halt tumor growth in both cellular and animal models. This line of inquiry extended to human clinical trials aimed at understanding whether its ability to regulate insulin could inhibit cancer progression.
Despite these efforts, randomized controlled trials struggled to deliver conclusive evidence of metformin’s efficacy against cancer. These trials, including those focused on prostate and breast cancers, revealed no significant improvement in patient survival rates, contradicting earlier studies that suggested a reduced cancer risk among metformin users. Early optimistic interpretations of metformin’s benefits may have been skewed by “immortal time bias,” a statistical error in clinical research.
Metformin use is significantly correlated with a lower risk of cardiometabolic diseases, all-cause mortality, and cardiometabolic mortality among U.S. cancer survivors, finds a study published in @BMCMedicine.https://t.co/ZVJujBpHEw
— BMC (@BioMedCentral) September 27, 2024
Scientific Scrutiny and Clinical Trials
The leap to using metformin as a cancer therapeutic remains fraught with challenges. High doses, promising in laboratory settings, pose risk for human use due to potential side effects. These concerns underscore why further trials are essential, particularly to explore metformin’s role in managing early-stage cancers or precancerous lesions.
“I always thought we were asking too much of metformin,” says Victoria Bae-Jump, a gynecological oncologist at the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill.
The push forward with metformin also includes its evaluation for other health benefits beyond diabetes and cancer, such as potential applications in delaying the onset of dementia and mitigating aging-related conditions. While some researchers express hope for its versatile potential, others exercise caution pending further evidence.
Diabetes drug #metformin may protect cells against radiation damage, a new #UTSW study published in @PLOSONE finds. https://t.co/GpupfjTw9I
— UTSW Simmons Cancer Center (@utswcancer) August 23, 2024
Future Prospects
As research continues, the question of whether metformin can practically contribute to cancer treatment or prevention remains open. Current clinical trials focus on better understanding specific contexts where metformin might prove beneficial, primarily targeting subsets of cancer patients who might respond to its mechanisms of action.
“It really has a reputation of being a potential wonder drug,” says Michael Pollak, an oncologist and researcher at McGill University in Montreal.
Such endeavors are crucial to validating its role in oncology and reconciling the optimism seen in preclinical research with practical clinical outcomes. With more robust trials and specific subgroup studies, metformin’s use in cancer could yet find its rightful place.
Sources:
- Why a diabetes drug fell short of anticancer hopes
- Metformin in Cancer Therapy: A New Perspective for an Old Antidiabetic Drug?
- Metformin and Cancer: Solutions to a Real-World Evidence Failure
