Goals met.

With losartan and arthritis drugs recently entering the spotlight of oncologic therapeutics, other bread and butter meds are ready to take their shot. And when looking to repurpose an already ubiquitous drug, where better to turn next than to metformin? Actually, metformin already has a lot of preclinical data supporting its antiproliferative effects and even hypothesis-generating retrospective associations with better cancer outcomes. This phase 2 trial randomized 139 patients (without diabetes) receiving an EGFR-TKI for stage IIIB-IV non-small cell lung cancer (NSCLC) to +/- the addition of metformin 500 mg twice daily. Intriguingly, the primary endpoint of progression-free survival was significantly improved from a median of 10 → 13 months with the addition of metformin. Not impressed? The addition of metformin also nearly doubled median overall survival from 18 → 32 months. TBL: The repurposing of standard-dose metformin as a component of standard care for advanced EGFR-mutant NSCLC improved survival in the phase 2 setting. | Arrieta, JAMA Oncol 2019