Metformin (cancer chemoprevention context)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-METFORMIN-CHEMOPREVENTION |
|---|---|
| Type | Drug |
| Aliases | DiaforminDimethylbiguanideGlucophageMetformin (cancer chemoprevention)SioforМетформін (хіміопрофілактика раку) |
| Status | reviewed 2026-05-18 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 SRC-WCRF-AICR-CUP-2018 |
Drug Facts
| Class | Biguanide oral antihyperglycemic |
|---|---|
| Mechanism | Activates AMP-activated protein kinase (AMPK) and inhibits hepatic gluconeogenesis (mitochondrial complex I inhibition); also lowers circulating insulin and IGF-1, which is the leading cancer-prevention hypothesis. Observational studies in type 2 diabetics show reduced incidence of colorectal, hepatocellular, pancreatic, and breast cancers vs. sulfonylureas. RCT evidence for cancer chemoprevention remains mixed (MA.32 adjuvant breast trial: no DFS benefit; ongoing prevention trials). |
| Typical dosing | Cancer chemoprevention (research/off-label): 500 mg PO daily start, titrate to 500-1500 mg/day (often 850 mg BID). Take with food to minimize GI side effects. Renal function check before initiation and annually. Withhold if eGFR <30 mL/min/1.73m²; caution at eGFR 30-45 (max dose typically 1000 mg/day). |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-05-18 |
Warnings
- Lactic acidosis — rare but potentially fatal; risk factors include renal impairment, hypoxic states, alcohol abuse, hepatic insufficiency, IV contrast administration
Notes
STUB — v0.2 chemoprevention-workstream authoring; pending two-Clinical- Co-Lead signoff per CHARTER §6.1 dev-mode. CANCER-CHEMOPREVENTION CONTEXT — distinct entity from a generic DRUG-METFORMIN for diabetes management. Evidence base: observational signals strong (T2DM cohorts show ~20-40% reduced cancer incidence), RCT evidence mixed/negative in adjuvant settings (MA.32: no benefit). NOT NCCN/ESMO/USPSTF guideline-recommended as standalone chemoprevention intervention. Reasonable adjunct in T2DM patients with hereditary cancer risk (Lynch, etc.) for combined glycemic + theoretical cancer benefit. Engine should NOT auto-recommend for cancer prevention alone.
Used By
No reverse references found in the YAML corpus.