One of the most important questions for people with LFS is whether there is anything that can be done to reduce the risks of developing cancer. Is there something in diet, exercise or lifestyle that can reduce the risks? One option that a number of researchers have been exploring is the use of the anti-diabetic drug metformin. There are good reasons to suppose that it might have some positive effects – some of the reasons were outlined in the two papers on LFS which I wrote a while back (the last one was Primed for cancer: Li Fraumeni Syndrome and the pre-cancerous niche). One of the people working on this in the lab has been Dr Paul Hwang, whom I interviewed a while back for my anticancer.org.uk blog.
The latest paper from Paul and colleagues is called ‘Inhibiting mitochondrial respiration prevents cancer in a mouse model of Li-Fraumeni syndrome’. The paper outlines a series of experiments in mice, backed up with human data, which shows that metformin can act to improve the cancer-free survival of mice genetically engineered to have LFS. The most important finding is that metformin, at equivalent doses to those that people take, extended cancer-free survival time by around 27%.
Obviously people are a lot more complicated than mice, and there is a whole range of different mutations in people with LFS compared to the single TP53 mutation in these mice. But with that in mind, it’s significant that the metformin doses used were in line with what people take. Of course what we really want is a cancer-reduction trial of metformin in people with LFS. But such trials are hard to do in rare medical conditions like LFS. Still, it’s really what we want to see more than anything.
It’s also true that metformin is only one of a number of drugs which may have risk-reducing effects. Low dose aspirin, probiotics, stress-reduction, berberine… There’s a whole list of things that would be worth exploring – and of course the idea of looking for synergistic combinations is incredibly appealing too. Who knows, perhaps metformin and low dose aspirin could reduce the risk a whole lot more than either drug alone.