Common Diabetic Drug Fights Cancer Stem Cells 149
SubtleGuest writes "In the latest issue of Cancer Research, a breakthrough study shows that Metformin, a cheap and common diabetic medicine, kills cancer stem cells — the cells postulated to be responsible for tumor resistance and recurrence after chemotherapy (research abstract here). It has been known that diabetics taking Metformin experience lower cancer rates, and now it is apparent why that may be and how it may apply to non-diabetics as well. When combined with Doxorubicin to kill non-stem cancer cells, the results are nothing short of astonishing: total remission in a mouse xenograft model. The results are achieved at levels below the dosage needed for diabetic control, opening many new avenues in cancer treatment and prevention."
I'm diabetic... (Score:5, Informative)
... and Metformin was one of the first drugs I tried. Too bad it made me feel HORRIBLE .
Not just all caps horrible, but bold and italic horrible, too. Fever, nausea, chills, cramps, and headache. We even tried ramping up the dose, starting in very small amounts, to no avail. Only afterward did the doctor tell me that a significant fraction of the population has the same reaction.
(I finally broke down and just took insulin and Actos. Works great to control blood sugar. Also works great for gaining weight.)
Re:Is medical advancement stagnating? (Score:5, Informative)
The frequency with which potential treatments are announced has increased, and the number of existing, effective treatments has increased (both of these pretty much work since whenever).
So you see more noise about things that might work, and those things face a higher bar when actually tested out, thus there are more failures.
If you step back and look at survival rates for various cancers, they have gone up significantly, even in just the last 10 years (some of this may simply be due to increased awareness of carcinogens, but some of it is likely to be due to better treatments).
Re:Non-human model systems (Score:5, Informative)
Translating these results into some meaningful treatment for normal adults is highly likely to face a lot of roadblocks and complexities.
I generally agree with this, but there are two things that raise this above the usual "cures cancer in mice" hype.
The first is that these are xenografts, which means they're dealing with authentic human cancers, which are in general far tougher to kill than cancers in other species (we are tuned up for great longevity for obvious evolutionary reasons, and therefore incredibly cancer resistant compared to most species, meaning the few human cancers that do become malignant are incredibly hard to kill.) A quick look at the paper shows they've used multiple cell lines for the xenographs, which is also good.
The second is that there is already evidence of reduced cancer rates in humans taking this stuff (pancreatic cancer only, and diabetics only, so limited but suggestive data.)
The full paper is available at:
http://cancerres.aacrjournals.org/cgi/reprint/69/19/7507 [aacrjournals.org]
and it really is one of the few on the topic that I'd honestly say has results that can fairly be characterized as "dramatic".
You're right: they may lead to another dead end. We've seen a lot of those before. But this looks like solid research and very promising results. Clinical trials on humans are in the works, with patient enrollment starting perhaps as soon as next year.
Re:Expect the price to go up, up, up. (Score:3, Informative)
Re:Non-human model systems (Score:4, Informative)
The interesting thing is that it's Metformin... That drug does several things at once (though it's side-effects make it such that you largely don't want it for it's carb-blocking ability...)- diabetics on that med tend to lose weight if they're solely on that one and abide by diet restrictions and are compliant with it. It'd be interesting what comes of the research.
Re:I'm diabetic... (Score:4, Informative)
Did you try the extended release Metformin - for many people that has lesser
side effects than the regular one.
The most common side effect of Metformin is an upset stomach & lots of farting.
But usually that subside after a month or so.
Metformin is really a wonder drug - if possible every diabetic should take it
- It's the one of the few diabetic medication which doesn't make you put on weight.
It usually results in a 3-4 pound weight loss.
- It never causes low blood sugar.
- It's cardioprotective. Diabetics on metformin reduce their chances of getting a heart
attack.
- It's dirt cheap if you take the generic.
- It helps with the Dawn Phenomenon [wikipedia.org]
It help starting with a very low dose of Metformin ER - say Metformin 500 Extended Release
once a day for a couple of weeks to see how it works for you - if you haven't already
tried the ER yet - then you can keep increasing dose - 750, 1000, 1500, 2000 till you find
the maximum dose you can tolerate.
If
Re:Is medical advancement stagnating? (Score:3, Informative)
On clinical trials [wikipedia.org]
History of FDA oversight [fda.gov]
On the Current act [wikipedia.org]
Again, I apologize for the US-centric linkage. Also, I do not work for the FDA
Re:I'm diabetic... (Score:4, Informative)
Re:Is medical advancement stagnating? (Score:4, Informative)
It's available now. Doctors in the U.S. are allowed to prescribe medication for off-label uses if it's approved for any use, so you might be able to get a prescription metformin for anti-cancer use this afternoon if you make a few calls. There may be a more general problem, but this is not a good illustration of it.
Re:I'm diabetic... (Score:3, Informative)
Perhaps you didn't read the summary, where it says it is used by mixing it in with a standard chemo drug? They only briefly say that maybe it could also be used as a preventative treatment. The big thing was a dramatic increase to the effectiveness of chemotherapy.
Re:Non-human model systems (Score:3, Informative)
Given the success rate of promising cancer treatments, it is a good bet that this won't pan out. That would also be true if it was something the industry could sell for a hundred times that: there's a low success rate for drugs in early stages of testing. If this treatment goes nowhere, we shouldn't assume the industry killed it to make more money, it is much much more likely that the results genuinely showed it didn't work.
I'm not trying to defend big pharma, I'm just saying we should avoid this circular logic of "Pharmaceuticals will try to kill this because it's so cheap" and then a few months later when it actually doesn't pan out, we say "Yup, pharmaceuticals killed it because it wasn't profitable." We should avoid that for two reasons, one is that even though big pharma does plenty of evil things, falsely accusing them of things doesn't help. The second is there's already a high likelyhood that when it doesn't pan out, quack doctors are going to be giving this to desperate cancer patients as "the miracle cure for cancer that the pharmecutical companies don't want you to know about so they can keep you sick and dependent on much much more expensive treatments."
Re:Expect the price to go up, up, up. (Score:4, Informative)
http://www.accessmylibrary.com/coms2/summary_0286-11275848_ITM [accessmylibrary.com]
Gee, thanks, I'll definately take that advice next time.
In 1987, the drug's creators had originally obtained a "methods" patent on using the combination of two generic vasodilators (hydralazine and isosorbide dinitrate) that seemed to have a pronounced beneficial effect in treating heart failure.
The methods patent, which expires in 2007, was not race-specific.
Soon thereafter the patent owners applied for a new race-specific methods patent to use the generic combination to treat heart failure in African-American patients.
If my knowledge of pharmecetical patents is so out of whack as to be foolish, that doesn't say a lot for the lawyers, judges, and patent inspectors involved in this case.
Re:Is medical advancement stagnating? (Score:1, Informative)
Many drugs are developed with a use in mind but are discovered to have other effects as well that often don't appear in clinical trials, primarily because the patient populations are homogenous and small, and we're not looking for them. Common examples are Plaquenil (antiprotozoal, more useful for immunosuppression), amantadine (antiviral, still works well for Parkinson's) and Viagra (originally a antihypertensive, frequent dosing limited it to the erectile dysfunction indication, used off-label and more recently approved for pulmonary arterial hypertension). There's nothing sinister going on here, it's how medical/pharmaceutical discovery routinely happens.