The addition of metformin at the dose used to treat diabetes did not improve outcomes in patients with metastatic pancreatic cancer treated with standard systemic therapy, according to an article published in Clinical Cancer Research.1

In this open-label randomized phase 2 trial, investigators sought to assess the safety and efficacy of metformin for treating patients with metastatic pancreatic cancer and to identify endocrine and metabolic phenotypic features or tumor molecular markers linked with sensitivity to metformin.

A total of 60 patients were randomly assigned (1:1) to receive standard systemic therapy with cisplatin, epirubicin, capecitabine, and gemcitabine (PEXG; 31 patients) every 4 weeks or PEXG in combination with 2 gm of oral metformin daily (29 patients).

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The study’s primary endpoint was 6-months progression-free survival (PFS-6) in the intention-to-treat population. It was ended for futility.

RELATED: In the Clinic: Metformin and Pancreatic Cancer

Results showed that PFS-6 was 52% (95% CI, 33 – 69) in the control group and 42% (95% CI, 24 – 59) in the metformin group (P = .61). There was no difference in disease-free survival or overall survival between the groups.

Although single-nucleotide polymorphism rs11212617 predicted glycemic response, it did not predict tumor response to metformin. Also, gene expression on tumor tissue did not predict tumor response.


  1. Reni M, Dugnani E, Cereda S, et al. (Ir)relevance of metformin treatment in patients with metastatic pancreatic cancer: an open-label randomized phase II trial. Clin Cancer Res. 2016;22(5):1076-1085.