Rethinking Healthcare

Metformin result shows everything old is new again

Metformin result shows everything old is new again

Posting in Cancer

If you're a smoker you could one day be treated with this diabetes drug and greatly reduce your risk of death from lung cancer. It's the tobacco industry's holy grail.

Old drugs are supposedly old. Excitement lies in the new.

Researchers spend careers creating new drugs, often designed to replace the old ones.

But breakthroughs can also come from taking another look at existing compounds.

We have seen this with aspirin, and now we're seeing it with metformin, a generic diabetes drug.

Metformin is the most commonly-prescribed diabetes drug in the world, with 42 million prescriptions in the U.S. alone last year. (Picture from Wikimedia Commons.)

It can prevent cancer?

Maybe so.

A National Cancer Institute study offered free this week at Cancer Prevention Research offers just this intriguing possibility.

The key, as with rapamycin, which I wrote about in April regarding Alzheimer's, is the mammalian target of rapamycin (mTOR), an essential signaling pathway in tumor progression.

After injecting medformin in mice who had been put on tobacco smoke and trying it orally on the same poor mice, the conclusion of lead researcher Regan Memmott rang like a shot:

metformin prevents tobacco carcinogen–induced lung tumorigenesis and supports clinical testing of metformin as a chemopreventive agent

In other words if you're a smoker you could one day be treated with this diabetes drug and greatly reduce your risk of death from lung cancer. It's the tobacco industry's holy grail.

The same journal took the unusual step of publishing two separate notes alongside the study:

  1. Jeffrey Engelman of Massachusetts General Hospital suggested there may be a link between insulin levels and mTOR signaling.
  2. Michael Pollak suggested that new research can be done not only with metformin, but with other drugs of the same type, called biguanides,  concerning both prevention and treatment of  cancer.

These are the kinds of reviews that lead to the big prizes. Dr. Memmott has a glorious career in front of her.

It reminds me a bit of the excitement over aspirin a few years ago. And of another point that is just as important to every reader.

The drugs in your medicine cabinet are powerful compounds. We think we know about them the way we do old friends, but science has yet to become truly intimate with any of them.

Respect them. Not just for what they are expected to do, but for what they might be doing we don't yet know about. Both bad and good.

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Dana Blankenhorn

Contributing Editor

Contributing Editor Dana Blankenhorn has written for the Chicago Tribune, Advertising Age's "NetMarketing" supplement and founded the Interactive Age Daily for CMP Media. He holds degrees from Rice and Northwestern universities. He is based in Atlanta. Follow him on Twitter. Disclosure