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2017 ; 2
(2
): e000132
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Results of the safety run-in part of the METAL (METformin in Advanced Lung
cancer) study: a multicentre, open-label phase I-II study of metformin with
erlotinib in second-line therapy of patients with stage IV non-small-cell lung
cancer
#MMPMID28761738
Morgillo F
; Fasano M
; Della Corte CM
; Sasso FC
; Papaccio F
; Viscardi G
; Esposito G
; Di Liello R
; Normanno N
; Capuano A
; Berrino L
; Vicidomini G
; Fiorelli A
; Santini M
; Ciardiello F
ESMO Open
2017[]; 2
(2
): e000132
PMID28761738
show ga
PURPOSE: Our previous works demonstrated the ability of metformin to revert
resistance to gefitinib, a selective epidermal growth factor receptor (EGFR)
tyrosine kinase inhibitor, in non-small-cell lung cancer (NSCLC) EGFR/LKB1
wild-type (WT) cell lines. However, the optimal dose of metformin to be used in
non-diabetic patients still remains to be defined. The phase I-II trial METformin
in Advanced Lung cancer (METAL) was designed to identify the maximum tolerated
dose and to evaluate safety and activity of metformin combined with erlotinib in
second-line treatment of patients with stage IV NSCLC, whose tumours harbour the
WT EGFR gene. PATIENTS AND METHODS: We report results from the safety run-in part
designed to detect acute toxicities, to study pharmacokinetics and to identify
the recommended phase II dose (RPD) to be used for the following phase of the
study. In the run-in phase, metformin treatment was administered according to a
dose escalation scheme and, subsequently, combined with erlotinib. RESULTS:
Twelve patients were enrolled. Common adverse events were diarrhoea, decreased
appetite, abdominal pain, vomiting and skin toxicity, mostly reversible with
symptomatic medical treatment. Dose-limiting toxicities were vomiting and
diarrhoea registered in the initial cohort receiving metformin 2000 mg plus
erlotinib at 150 mg die, which was declared the maximum administered dose. Only
one of nine patients treated at the next lower dose of 1500 mg of metformin plus
erlotinib at 150 mg experienced G3 gastrointestinal toxicity. Metformin
plasma-concentration profile confirmed the trend already observed in non-diabetic
population. Glycemic profiles showed stability of the blood glucose level within
the physiological range for non-diabetic subjects. At a follow-up of 30 weeks,
six (50%) patients experienced a disease control (5 SD and 1 partial response).
CONCLUSIONS: The RP2D of metformin dose was defined at 1500 mg/day to be combined
with erlotinib 150 mg. TRIAL REGISTRATION NUMBER: EudraCT number: 2014-000349-59.