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Teaching an old drug new tricks

Metformin is commonly used to control blood sugar levels in people with type II diabetes. Current renewed interest in the drug all started back in 2003, when three research groups, including Worldwide Cancer Research funded Professor Dario Alessi, published astonishing data suggesting it could be a potent new anticancer drug.

Professor Alessi’s team was able to establish one of the first clear links showing cancer could in part be driven by faulty metabolic processes (how the cells use energy).

Based on their findings he approached Professor Andrew Morris, a prominent diabetes doctor, about checking his patient database.

Professor Alessi told us “At first he thought I was mad, I had to speak to him 3 or 4 times, before he agreed to do a retrospective analysis of his database.  When he did, he randomly selected patients who did or did not take metformin for diabetes.

As I had predicted, there was 20-25% fewer cancer diagnoses in those who took metformin, and we published these findings in the British Medical Journal BMJ. Since then there have been around 30-40 papers from epidemiologists, who also confirm this 20-25% reduction, suggesting metformin has a protective effect against the disease.”

This work helped kick off a whole new era of research investigating cancer metabolism. And metformin has been in the spotlight ever since.

There are currently over 200 clinical trials investigating metformin’s potential activity against many different types of cancer, including bowel cancer, prostate cancer, and melanoma skin cancer.  In fact, one of the trials for melanoma skin cancer, is also taking place thanks to our funding of Professor Richard Marais, who at that time worked at the Institute of Cancer Research.

Professor Marais found that the combination of metformin and a type of drug called anti-VEGF were more efficient than the anti-VEGF drugs alone, and this treatment is currently being investigated in melanoma patients, in a phase II clinical trial.

Worldwide Cancer Research is proud to have supported both Professor Alessi’s and Professor Marais’ ground-breaking work.

Professor Alessi told us “When we started working on this, it was a completely new project. We had very little preliminary data, the committee showed a very big act of faith.  Worldwide Cancer Research funding was absolutely critical, nothing would have happened in this area without this funding, no bit of funding I have received has ever achieved quite so much.”

Metformin is no ‘miracle cure’, and it’s not without side-effects.  Much work needs to be done to establish if, and how, metformin could potentially help patients at risk of cancer. But thanks to that early research carried out by Professor Alessi and others, today we are much closer to finding out.