Category: MPhil/PHD Pharmacology
Status: Awaiting IRB approval for Phase 2 of the study to commence, whilst analysis of Phase 1 continues.
Background: Metformin is commonly prescribed to patients with Type 2 diabetes mellitus and its use has been reportedly linked to a reduced risk of cancer in patients with the disease. Metformin’s exact antineoplastic mechanisms of actin remain unclear, with no studies being among Afro-Caribbean populations. In the 2008 annual report of the Barbados National Registry of cancer, this cancer was among the top five cancer sites recorded in women, with a 5-year survival rate of 51% (X). Women most at risk are those who are obese, postmenopausal and have Type 2 diabetes.
Objectives: To determine whether metformin use, of any dose or duration is superior to use as an alternative hypoglycemic agent, or lifestyle modification, at delaying the diagnosis of endometrial cancer in Barbadian postmenopausal women with Type 2 diabetes. As seen by the rising number of endometrial cancer cases in Barbados and the world, this study is novel and relevant, and hopes to add to the knowledge bank of revolutionizing the treatment of endometrial cancer whilst generating a new body of information relating to care amongst Barbadian and global black populations.
Project Outline: Currently in phase one, this study is retrospectively examining the time it took a cohort of Barbadian, post-menopausal women with Type 2 Diabetes to develop endometrial cancer after starting metformin or an alternative anti-diabetic treatment strategy. In its second phase, it will examine, using immunohistochemistry, homogenates extracted from uterine specimens, focusing on the P13K/AKT/mTOR, p53 and Cyclin D signaling pathways and Phospho-S6rp, MAPK and Phospho-AKT biomarkers. Specimens will some from Barbadian post-menopausal women with and without endometrial cancer 9already scheduled for hysterectomy), who have and had not had metformin exposure in the past. Any differences found between specimen groups, based on metformin exposure and possible time and dose-response relations will be noted.