Diabetes drug kept breast tumors away in mice

Adding the common diabetes drug metformin to chemotherapy helped shrink breast cancer tumors faster in mice and keep them away longer than chemotherapy alone, raising hope for a more effective way to treat cancer, U.S. researchers said on Monday.

They said metformin appeared to target breast cancer stem cells — a kind of master cancer cell that resists conventional treatment and may be the source of many tumors that grow back.

“What’s exciting here is we now have something that is mechanistically a different kind of killer of cancer that can synergize with chemotherapy,” Kevin Struhl of Harvard Medical School, whose study appears in the journal Cancer Research, said in a telephone briefing.

Many teams have been looking for ways to destroy the master cancer cells in the hope of making cancer easier to cure.

Last month, a team at the Broad Institute of Harvard and the Massachusetts Institute of Technology reported that a chemical called salinomycin could kill breast cancer stem cells.

What is different with his study, Struhl said, is that metformin is a widely used drug with a long safety track record. “There are tens of millions of people who take this drug,” he said.

“Although our studies are limited to mice and cells, metformin has a history of anti-cancer effects,” he said.

Metformin has already been shown to reduce the risk of some cancers, including pancreatic and breast cancer, in large studies of people with diabetes.

Struhl said metformin’s affect on cancer stem cells appeared to be separate from its ability to help the body use insulin and lower blood sugar — which also can improve breast cancer survival.

His team studied metformin and the cancer drug doxorubicin in lab dishes and found they killed both human cancer stem cells and non-stem cancer cells.

Mice that had tumors and got metformin and chemotherapy were less likely to have tumors grow back two months after treatment compared with mice that got chemotherapy alone.

“When we had both drugs together, we lost the tumors faster, but more importantly, there was no relapse,” Struhl said.

He said with metformin, it may be possible to reduce the chemotherapy dose and still get the same benefit.

That will need to be studied in people and a study is getting under way. Dr. Jennifer Ligibel, at Dana-Farber Cancer Institute and Harvard, is organizing a large trial with colleagues in Canada to study metformin in women with early stage breast cancer.

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More women having a healthy breast removed

A small but growing number of women with breast cancer are choosing to have the unaffected breast removed in an effort to prevent a recurrence, researchers reported Monday.

Using data from New York State hospitals, the researchers found that between 1995 and 2005, the prevalence of preventive mastectomy among women with a history of cancer in one breast more than doubled.

The procedure was performed in about 2 percent of all women diagnosed with breast cancer in 1995 and 1996 — rising to just over 4 percent by 2005.

In contrast, there was only a small increase in preventive mastectomies among women who had no personal history of breast cancer but were considered at risk because of a strong family history of the disease.

The findings suggest that while the number of preventive mastectomies performed each year in New York was small, the procedure is becoming more common, the researchers report in the journal Cancer.

The more marked increase among women with a history of breast cancer raises some concerns, senior researcher Dr. Stephen B. Edge, of the Roswell Park Cancer Institute in Buffalo, told Reuters Health.

The central issue, he explained, is that there is no evidence that removing the unaffected breast improves long-term survival.

While preventive mastectomy likely cuts the chances of cancer developing in the second breast, the ultimate impact on survival is a more complicated matter.

Edge noted that among women who are not at high genetic risk of breast cancer — about 95 percent of all breast cancer patients — the odds of developing cancer in the second breast are between 10 percent and 20 percent over 20 to 30 years.

So in deciding whether to have a preventive mastectomy, women need to consider the uncertain long-term benefits and the risk of complications — which include bleeding, infection and nerve damage.

“Women need to be carefully counseled on the issues of the risks of developing a second cancer, and the largely minimal or no impact this may have on their survival,” Edge said.

The study findings are based on data from hospital discharge records and the New York State cancer registry. Of the nearly 70,000 women who underwent mastectomies between 1995 and 2005, 9 percent — 6,275 women — had one for preventive reasons.

Of women having a preventive mastectomy, 81 percent had a history of breast cancer. The number of these procedures rose from 295 in 1995 to 683 in 2005.

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Diabetes drug kept breast tumors away in mice

Diabetes drug kept breast tumors away in mice

More women having a healthy breast removed

More women having a healthy breast removed