Professor, Department of Pathology and Molecular Medicine
Queen's University, Kingston
National Cancer Institute Canada Clinical Trials Group
Co-Investigator: Pamela J. Goodwin, MD, MSc., FRCP(C), Mount Sinai Hospital, University of Toronto
The National Cancer Institute of Canada Clinical Trials Group (NCIC CCTG) is conducting a randomized phase III trial of metformin compared with placebo on recurrence and survival in early stage breast cancer. This is a study that is being conducted across North America, the United Kingdom, and Switzerland, and it involves a variety of cooperative groups from the United States and the NCIC CTG in Canada. Metformin is a very old drug which is used in the treatment of adult onset diabetes. Over the last decade there has been a growing body of evidence to suggest that insulin and insulin growth factor pathways may play a role in the development and recurrence of many malignancies including breast cancer. Metformin has both a direct and indirect mechanism of action on the insulin pathway and its potential use in preventing the recurrence of early stage breast cancer is being explored in the MA.32 study. The study was activated in the summer of 2010 and closed to accrual in North American on January 22, 2013, six months ahead of the projected date. To date, 2,259 of the final sample size of 3,649 women were recruited from the United States with 1,203 women from Canada and an additional 187 women from the UK and Switzerland. Ongoing follow-up continues. Some early biological studies conducted on blood samples collected from participants have demonstrated that metformin has achieved the anticipated effect on body mass index, weight, glucose and insulin levels.
Ongoing follow-up continues in this novel phase III trial of metformin in the adjuvant breast cancer setting, the results of which may provide another effective treatment option with early stage breast cancer. Some early biological studies conducted on blood samples collected from participants have demonstrated that metformin has achieved the anticipated effect on body mass index, weight, glucose and insulin levels.
Dr. Shepherd is a Hematopathologist and Professor in the Department of Pathology and Molecular Medicine at Queen's University in Kingston, Ontario and has worked as a Physician Coordinator and Senior Investigator at the NCIC Clinical Trial Group since 1988. Dr. Shepherd has been responsible for oversight of the Breast and Hematology trial activity within the group for the last 20 years. As well, she is the Operational Director of the Tumour, Tissue and Data Repository established in 1997 which is the biorepository for tissue collected in association with the Group's clinical trials. Dr. Shepherd's interests are in hematologic malignancies, transfusion medicine, breast cancer, translational research and biobanking. She has more than 70 peer-reviewed publications.