Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica
Background: Metformin shows anti-proliferative effect on tumor cells. We studied the effect of metformin on achieving complete pathological response (pCR) in breast cancer patients receiving neoadjuvant therapy in a Latin American population. Methods: We conducted a cross-sectional study in Mexico...
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| Format: | Article |
| Language: | English |
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Kaviani Breast Disease Institute
2018-03-01
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| Series: | Archives of Breast Cancer |
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| Online Access: | https://archbreastcancer.com/index.php/abc/article/view/163 |
| _version_ | 1819290541372735488 |
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| author | Alicia Van der Laat Allan Ramos-Esquivel Denis Ulises Landaverde |
| author_facet | Alicia Van der Laat Allan Ramos-Esquivel Denis Ulises Landaverde |
| author_sort | Alicia Van der Laat |
| collection | DOAJ |
| description | Background: Metformin shows anti-proliferative effect on tumor cells. We studied the effect of metformin on achieving complete pathological response (pCR) in breast cancer patients receiving neoadjuvant therapy in a Latin American population.
Methods: We conducted a cross-sectional study in Mexico Hospital, Costa Rica, from January 2007 to December 2015. Women with early-stage or locally advanced breast cancer receiving neoadjuvant systemic treatment were recruited for the study. Univariate and multivariate models were used to compare the pCR rate with metformin plus standard therapy versus standard treatment alone.
Results: Of 53 included women with early-stage or locally advanced breast cancer were included, 14 received metformin with systemic therapy, and 39 had systemic therapy alone. Only 15% of the patients had diabetes mellitus. The pCR rate was in the metformin group was 64.3% compared with 23.1% in the systemic therapy-alone group (OR: 6.0, 95% CI: 1.60–22.53, P= 0.008). This finding was confirmed after adjustment for potential confounders, suggesting that the use of metformin increased the pCR likelihood regardless of breast cancer subtype (adjusted OR: 5.56, 95% CI: 1.27–24.3, P = 0.02). There was a trend of achieving pCR in patients with Ki-67 > 55%. However, it did not reach statistical significance when metformin was added, suggesting that probably a high Ki-67 level in the presence of metformin is not a predictor factor of pCR.
Conclusion: This is the first study conducted in a Latin American population showing that metformin with systemic therapy increases pCR regardless of the intrinsic molecular subtype or Ki-67 levels. These findings encourage prospective studies to evaluate the role of neoadjuvant metformin in this population. |
| first_indexed | 2024-12-24T03:24:23Z |
| format | Article |
| id | doaj.art-091a77822a69484ba498c9410a0620c5 |
| institution | Directory Open Access Journal |
| issn | 2383-0433 |
| language | English |
| last_indexed | 2024-12-24T03:24:23Z |
| publishDate | 2018-03-01 |
| publisher | Kaviani Breast Disease Institute |
| record_format | Article |
| series | Archives of Breast Cancer |
| spelling | doaj.art-091a77822a69484ba498c9410a0620c52022-12-21T17:17:24ZengKaviani Breast Disease InstituteArchives of Breast Cancer2383-04332018-03-015110.19187/abc.20185132-37Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa RicaAlicia Van der Laat0Allan Ramos-Esquivel1Denis Ulises Landaverde2Department of Hemato-Oncology, Mexico Hospital, San Jose, Costa RicaDepartment of Hemato-Oncology, Hospital San Juan de Dios, San Jose, Costa RicaDepartment of Hemato-Oncology, Mexico Hospital, San Jose, Costa RicaBackground: Metformin shows anti-proliferative effect on tumor cells. We studied the effect of metformin on achieving complete pathological response (pCR) in breast cancer patients receiving neoadjuvant therapy in a Latin American population. Methods: We conducted a cross-sectional study in Mexico Hospital, Costa Rica, from January 2007 to December 2015. Women with early-stage or locally advanced breast cancer receiving neoadjuvant systemic treatment were recruited for the study. Univariate and multivariate models were used to compare the pCR rate with metformin plus standard therapy versus standard treatment alone. Results: Of 53 included women with early-stage or locally advanced breast cancer were included, 14 received metformin with systemic therapy, and 39 had systemic therapy alone. Only 15% of the patients had diabetes mellitus. The pCR rate was in the metformin group was 64.3% compared with 23.1% in the systemic therapy-alone group (OR: 6.0, 95% CI: 1.60–22.53, P= 0.008). This finding was confirmed after adjustment for potential confounders, suggesting that the use of metformin increased the pCR likelihood regardless of breast cancer subtype (adjusted OR: 5.56, 95% CI: 1.27–24.3, P = 0.02). There was a trend of achieving pCR in patients with Ki-67 > 55%. However, it did not reach statistical significance when metformin was added, suggesting that probably a high Ki-67 level in the presence of metformin is not a predictor factor of pCR. Conclusion: This is the first study conducted in a Latin American population showing that metformin with systemic therapy increases pCR regardless of the intrinsic molecular subtype or Ki-67 levels. These findings encourage prospective studies to evaluate the role of neoadjuvant metformin in this population.https://archbreastcancer.com/index.php/abc/article/view/163Breast cancerLatin AmericaMetforminNeoadjuvant therapy |
| spellingShingle | Alicia Van der Laat Allan Ramos-Esquivel Denis Ulises Landaverde Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica Archives of Breast Cancer Breast cancer Latin America Metformin Neoadjuvant therapy |
| title | Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica |
| title_full | Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica |
| title_fullStr | Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica |
| title_full_unstemmed | Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica |
| title_short | Neoadjuvant Metformin Added to Systemic Therapy Increases Pathological Complete Response in Breast Cancer: A Cross-sectional Study, Mexico Hospital, Costa Rica |
| title_sort | neoadjuvant metformin added to systemic therapy increases pathological complete response in breast cancer a cross sectional study mexico hospital costa rica |
| topic | Breast cancer Latin America Metformin Neoadjuvant therapy |
| url | https://archbreastcancer.com/index.php/abc/article/view/163 |
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