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Evaluation of metformin in early breast cancer: a modification of the traditional paradigm for clinical testing of anti-cancer agents

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Abstract

Metformin, an inexpensive oral agent commonly used to treat type 2 diabetes, has been garnering increasing attention as a potential anti-cancer agent. Preclinical, epidemiologic, and clinical evidences suggest that metformin may reduce overall cancer risk and mortality, with specific effects in breast cancer. The extensive clinical experience with metformin, coupled with its known (and modest) toxicity, has allowed the traditional process of drug evaluation to be shortened. We review the rationale for a modified approach to evaluation and outline the key steps that will optimize development of this agent in breast cancer, including discussion of a Phase III adjuvant trial (NCIC MA.32) that has recently been initiated.

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Authors and Affiliations

  1. Department of Medicine, Division of Clinical Epidemiology at the Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, 1284-600 University Avenue, Toronto, ON, M5G 1X4, Canada

    Pamela J. Goodwin

  2. Division of Signaling Biology, Ontario Cancer Institute, University Health Network, Toronto, ON, Canada

    Vuk Stambolic

  3. Centre Hospitalier Affilié Universitaire de Québec, Université Laval , Quebec City, QC, Canada

    Julie Lemieux

  4. NCIC Clinical Trials Group, Queen’s University, Kingston, ON, Canada

    Bingshu E. Chen, Wendy R. Parulekar & Lois E. Shepherd

  5. British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada

    Karen A. Gelmon

  6. Department of Medicine, Columbia University Medical Center, New York, NY, USA

    Dawn L. Hershman

  7. Department of Oncology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Timothy J. Hobday

  8. Dana Farber Cancer Institute, Boston, MA, USA

    Jennifer A. Ligibel

  9. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Ingrid A. Mayer

  10. Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada

    Kathleen I. Pritchard

  11. Department of Radiation Oncology, Cancer Care Ontario, Juravinski Cancer Center, Hamilton, ON, Canada

    Timothy J. Whelan

  12. National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh, PA, USA

    Priya Rastogi

  13. University of Pittsburgh Cancer Institute (UPCI), University of Pittsburgh, Pittsburgh, PA, USA

    Priya Rastogi

Authors
  1. Pamela J. Goodwin
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  2. Vuk Stambolic
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  3. Julie Lemieux
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  4. Bingshu E. Chen
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  5. Wendy R. Parulekar
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  6. Karen A. Gelmon
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  7. Dawn L. Hershman
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  8. Timothy J. Hobday
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  9. Jennifer A. Ligibel
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  10. Ingrid A. Mayer
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  11. Kathleen I. Pritchard
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  12. Timothy J. Whelan
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  13. Priya Rastogi
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  14. Lois E. Shepherd
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Corresponding author

Correspondence to Pamela J. Goodwin.

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Goodwin, P.J., Stambolic, V., Lemieux, J. et al. Evaluation of metformin in early breast cancer: a modification of the traditional paradigm for clinical testing of anti-cancer agents. Breast Cancer Res Treat 126, 215–220 (2011). https://doi.org/10.1007/s10549-010-1224-1

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  • DOI: https://doi.org/10.1007/s10549-010-1224-1

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