Antitumor effects of metformin or atorvastatin as adjuvant therapies to neoadjuvant chemotherapy in non-metastatic breast cancer
Keywords:
Atorvastatin, Breast cancer, caspase-3, Ki-67, RECIST1, metformin, Clinical trialAbstract
Breast cancer remains the most common life-threatening malignancy among women worldwide. This randomized, placebo-controlled study evaluated the antitumor effects of metformin or atorvastatin as adjuvant therapies combined with neoadjuvant chemotherapy in 90 patients with non-metastatic breast cancer. Patients received either the AC-T regimen (doxorubicin cyclophosphamide, and paclitaxel) with placebo, metformin (1,000 mg/day), or atorvastatin (20 mg/day) for 24 weeks. Serum levels of vascular endothelial growth factor (VEGF), Ki-67, and caspase-3 were assessed before and after treatment, and radiological and pathological responses were evaluated using RECIST 1.1 and Miller–Payne criteria. Either metformin or atorvastatin significantly reduced VEGF and Ki-67 levels and increased caspase-3 compared to the control group, indicating suppression of tumor proliferation and enhanced apoptosis. These effects were associated with improved radiological and pathological responses. Atorvastatin showed greater effects on VEGF reduction and caspase-3 elevation, in addition to cardioprotective activity against doxorubicin-induced toxicity. Both agents enhanced therapeutic outcomes in patients with non-metastatic breast cancer.
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