Cancer Antigen 15-3/Mucin 1 Levels in CCTG MA.32: A Breast Cancer Randomized Trial of Metformin vs Placebo.


Journal

JNCI cancer spectrum
ISSN: 2515-5091
Titre abrégé: JNCI Cancer Spectr
Pays: England
ID NLM: 101721827

Informations de publication

Date de publication:
10 2021
Historique:
received: 14 04 2021
revised: 15 06 2021
accepted: 26 07 2021
entrez: 6 9 2021
pubmed: 7 9 2021
medline: 7 9 2021
Statut: epublish

Résumé

Circulating levels of cancer antigen (CA) 15-3, a tumor marker and regulator of cellular metabolism, were reduced by metformin in a nonrandomized neoadjuvant study. We examined the effects of metformin (vs placebo) on CA 15-3 in participants of MA.32, a phase III randomized trial in early-stage breast cancer. A total of 3649 patients with T1-3, N0-3, M0 breast cancer were randomly assigned; pretreatment and 6-month on-treatment fasting plasma were centrally assayed for CA 15-3. Genomic DNA was analyzed for the rs11212617 single nucleotide polymorphism. Absolute and relative change of CA 15-3 (metformin vs placebo) were compared using Wilcoxon rank and Mean (SD) age was 52.4 (10.0) years. The majority of patients had T2/3, node-positive, hormone receptor-positive, HER2-negative breast cancer treated with (neo)adjuvant chemotherapy and hormone therapy. Mean (SD) baseline CA 15-3 was 17.7 (7.6) and 18.0 (8.1 U/mL). At 6 months, CA 15-3 was statistically significantly reduced in metformin vs placebo arms (absolute geometric mean reduction in CA 15-3 = 7.7% vs 2.0%, Our observation that metformin reduces CA 15-3 by approximately 6% was corroborated in a large placebo-controlled randomized trial. The clinical implications of this reduction in CA 15-3 will be explored in upcoming efficacy analyses of breast cancer outcomes in MA.32.

Sections du résumé

Background
Circulating levels of cancer antigen (CA) 15-3, a tumor marker and regulator of cellular metabolism, were reduced by metformin in a nonrandomized neoadjuvant study. We examined the effects of metformin (vs placebo) on CA 15-3 in participants of MA.32, a phase III randomized trial in early-stage breast cancer.
Methods
A total of 3649 patients with T1-3, N0-3, M0 breast cancer were randomly assigned; pretreatment and 6-month on-treatment fasting plasma were centrally assayed for CA 15-3. Genomic DNA was analyzed for the rs11212617 single nucleotide polymorphism. Absolute and relative change of CA 15-3 (metformin vs placebo) were compared using Wilcoxon rank and
Results
Mean (SD) age was 52.4 (10.0) years. The majority of patients had T2/3, node-positive, hormone receptor-positive, HER2-negative breast cancer treated with (neo)adjuvant chemotherapy and hormone therapy. Mean (SD) baseline CA 15-3 was 17.7 (7.6) and 18.0 (8.1 U/mL). At 6 months, CA 15-3 was statistically significantly reduced in metformin vs placebo arms (absolute geometric mean reduction in CA 15-3 = 7.7% vs 2.0%,
Conclusions
Our observation that metformin reduces CA 15-3 by approximately 6% was corroborated in a large placebo-controlled randomized trial. The clinical implications of this reduction in CA 15-3 will be explored in upcoming efficacy analyses of breast cancer outcomes in MA.32.

Identifiants

pubmed: 34485814
doi: 10.1093/jncics/pkab066
pii: pkab066
pmc: PMC8410139
doi:

Substances chimiques

MUC1 protein, human 0
Mucin-1 0
Placebos 0
Metformin 9100L32L2N

Types de publication

Clinical Trial, Phase III Journal Article Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Subventions

Organisme : NCI NIH HHS
ID : P50 CA098131
Pays : United States
Organisme : NCI NIH HHS
ID : U10 CA180888
Pays : United States

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press.

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Auteurs

Pamela J Goodwin (PJ)

Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, and Department of Medicine, University of Toronto, Toronto, ON, Canada.

Ryan J O Dowling (RJO)

Hoffman-La Roche Limited, Mississauga, ON, Canada.

Marguerite Ennis (M)

Applied Statistician, Markham, ON, Canada.

Bingshu E Chen (BE)

Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada.

Wendy R Parulekar (WR)

Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada.

Lois E Shepherd (LE)

Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada.

Karen A Gelmon (KA)

University of British Columbia, BC Cancer Agency, Vancouver, BC, Canada.

Timothy J Whelan (TJ)

McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada.

Jennifer A Ligibel (JA)

Dana-Farber Cancer Institute, Boston, MA, USA.

Dawn L Hershman (DL)

Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, NY, USA.

Ingrid A Mayer (IA)

Vanderbilt University, Nashville, TN, USA.

Timothy J Hobday (TJ)

Mayo Clinic, Rochester, MN, USA.

Priya Rastogi (P)

NRG Oncology and University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Manuela Rabaglio-Poretti (M)

IBCSG and Department of Oncology, Bern University Hospital, University of Bern, Bern, Switzerland.

Julie Lemieux (J)

CHU de Québec-Université Laval, Québec, QC, Canada.

Alastair M Thompson (AM)

Baylor College of Medicine, Houston, TX, USA.

Daniel W Rea (DW)

Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.

Vuk Stambolic (V)

Department of Medical Biophysics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada and University of Toronto, Toronto, ON, Canada.

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