Friday 11 September 2015

Metformin for Low Grade Maintenance or Not?

I have residual, yet stable low grade oligodendroglioma. I'm trying to decide whether Metformin is worth taking or whether it could potentially contribute to a resistant mutation in the future. I've looked for some research but can't find any. Anyone have a theory on this?
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11 comments:

  1. Raphael12 September 2015 at 16:09

    It really is difficult to decide .
    The question is whether the use of certain medications or supplements can induce more resistant mutations or increase in tumor grade .
    It is not easy to decide , does anyone have any thoughts on this ??

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  2. Stephen W12 September 2015 at 18:00

    My opinion is that metformin would not be one of the drugs most likely to cause resistance. Because metformin is not actually cytotoxic. It takes around 1 mM of metformin to be toxic to cells in vitro, which is about 100 times higher than the levels of metformin in blood plasma. Instead metformin likely works through systemic effects on glucose, insulin, and potentially immune effects as well. I consider this to be a good choice for long-term management, unlike directly cytotoxic drugs which are more likely generate future resistance (due to more powerful evolutionary selection pressures).

    Also metformin is not a mutagen, so you wouldn't get anything like the TMZ-induced hypermutation phenomenon.

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  3. Anjok13 September 2015 at 02:30

    Dear Danny,
    my wife has a low grade astrocytoma in the brain stem. She is now taking metfromin for a few months and there are no problems so far. I see it the same way as Stephen described it in the previous post.

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  4. Danny Mercer13 September 2015 at 18:04

    I really wish I could get a prescription here. I'm going to press my NO on Thursday now that I've been on it for a month. I hope we don't have a falling out.

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  5. Stephen W13 September 2015 at 18:14

    Have you asked your general practitioner for a metformin prescription? My friend doesn't even bother asking her oncologist for prescriptions for non-cancer drugs. She goes to her family doctor instead for this sort of prescription.

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  6. Danny Mercer13 September 2015 at 19:12

    I've been using my NO as my GP. I guess I need to find me a primary.

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  7. Matjaz17 September 2015 at 00:09

    Hello!

    I also have low grade glioma and will also undergo surgery in a few months. I also don't want to contribute to a resistant mutation in the future so could someone please write what other supplements are they taking besides metformin.

    Thanks a lot!

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  8. Anjok17 September 2015 at 02:47

    Hi Matjaz, you can look at the diffrent cocktail posts. My wife has also a low grade glioma and you could look at her cocktail that I described in my post.

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  9. Anjok17 September 2015 at 02:51

    I forgot to mentioned, a good starting point is to read the astrocytomaoptions site from Stephen. This is to my knowledge the best source of glioma related information on the net.

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  10. Matjaz17 September 2015 at 03:30

    Thank you for your answer!
    The thing is that my tumor is in right temporal lobe/insula, so at preliminary appointment with neurosurgeon he said he may be able to remove all of it visible on MRI, so maybe no chemo will be necessary for now. But as he said, these things have a recurrence in 100%.

    As far as I understand you guys, I should just take supplements that enhance the immune system but are not cytotoxic (so they won't make tumor cells more resistant in the future)?

    PS: what is with these neurosurgeons? I heard that many of them are egocentric and such, this one just confirmed that. As you may imagine I was already really crushed by all this, then at the end of the appointment I asked him if he has any encouraging words for glioma patients...he replied with a cold "no". He didn't want to hear about drug cocktail approach. Really, what the F*** :) ?!

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  11. Anjok17 September 2015 at 05:23

    We had also very mixed experience with the doctors. I could write a book about it :-(. The most annoying thing for me is if the doctor is not up to date. They don’t have to spend hours every day on pubmed but should be able to tell what are the most important ongoing clinical trials and their results.

    I can only suggest to always get a second or third opinion. If possible you should try to do the surgery at a big center that is specialized on brain tumors. In Europe this is mostly the case with the university clinics. These clinics have on average more experience and better equipment for such surgeries. This is reducing the risk for any side effect and increasing the chance to get an optimal result.

    I would not agree with the statement that there is a 100% recurrence rate for a low grade glioma. But even if, we are talking hopefully about many years and decades. In that time there will be new treatment options and also we will know more how to optimize our cocktail approach.

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