A systems pharmacokinetic and pharmacodynamic approach to identify opportunities and pitfalls in energy stress-mediated chemoprevention: the use of metformin and other biguanides

Curr Drug Targets. 2012 Dec;13(14):1876-84. doi: 10.2174/138945012804545614.

Abstract

Metformin, a widely used anti-hyperglycemic drug in the biguanide class, is currently under investigation for the prevention of cancer. Surprisingly however, considering the time and cost of clinical chemoprevention trials and the current scrutiny of cancer chemoprevention, limited attention has been given to integrating available data, identifying the subpopulations most likely to benefit, or to quantitatively understanding the potential pitfalls of biguanide chemoprevention. Herein, a physiologically-based pharmacokinetic (PBPK) and pharmacodynamic framework is proposed for integrating information on physicochemical, cell-based, animal, and human studies of various biguanides to identify gaps in knowledge and to build a systems model that may facilitate the planning of randomized cancer chemoprevention trials of metformin.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Biguanides / pharmacokinetics*
  • Biguanides / pharmacology
  • Biguanides / therapeutic use
  • Chemoprevention / methods
  • Chemoprevention / trends
  • Energy Metabolism / drug effects
  • Energy Metabolism / physiology*
  • Humans
  • Hypoglycemic Agents / pharmacokinetics*
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Metformin / pharmacokinetics*
  • Metformin / pharmacology
  • Metformin / therapeutic use
  • Neoplasms / drug therapy
  • Neoplasms / metabolism*
  • Neoplasms / prevention & control
  • Oxidative Stress / drug effects
  • Oxidative Stress / physiology*

Substances

  • Biguanides
  • Hypoglycemic Agents
  • Metformin