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Thomas Guerrero



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    P1 - Poster Viewing (ID 5)

    • Event: NACLC 2019
    • Type: Poster Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 10/11/2019, 16:45 - 18:00, Exhibit Hall
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      P1.20 - Metabolic Responses to Metformin in Early-stage NSCLC Treated With Definitive Radiotherapy: Results of a Phase II Trial (ID 8)

      16:45 - 18:00  |  Author(s): Thomas Guerrero

      • Abstract

      Background:
      Metformin reduces glucose uptake in physiologic tissues and has been shown to affect non-small cell lung cancer (NSCLC) metabolism. We hypothesized that PET-scans could detect the impact of metformin on glucose uptake in NSCLC and we sought to prospectively test this hypothesis in a prospective clinical trial.


      Method:
      A single-blinded Phase II clinical trial was performed with subjects randomized 6:1 to 3-4 weeks of metformin vs. placebo for inoperable early-stage NSCLC. PET-scans were performed at baseline, mid-treatment (after 2 weeks study medication), and 6 months post-radiation. Stereotactic body radiotherapy (SBRT) to 50 Gy in 4 fractions was used for peripheral tumors and 70 Gy


      Results:
      There were 14 subjects randomized to the metformin and one to placebo. Histologies were 60% adenocarcinoma, 33.3% squamous cell carcinoma, and 6.7% poorly-differentiated carcinoma. At mid-treatment PET-scan, 57% of subjects randomized to metformin met PERCIST criteria for metabolic response, of which 75% had progressive metabolic disease (PMD) and 25% had partial metabolic response (PMR), whereas the placebo subject had stable metabolic disease (SMD). At 6 months, the metformin arm had 69% complete metabolic response (CMR), 23% PMR and one PMD, and the subject treated with placebo had a CMR. There were no CTCAE grade ? 3 toxicities.


      Conclusion:
      Majority of subjects treated with metformin had metabolic responses by PERCIST criteria on PET-imaging. Contrary to the effect of metformin on in physiologic tissues, most metabolic responses showed evidence of increased glucose uptake. Further study is needed to understand the mechanistic basis for and the clinical impact of these metabolic responses.