A single center retrospective study to examine the effect of concomitant metformin treatment on cisplatin induced nephrotoxicity in adult HNSCC patients between 2015-2021

Purpose Examine the effect of AMPK activation in addition to OCT2 competitive blockage through metformin concomitant treatment on the incidence rate of nephrotoxicity in adult head and neck cancer patients treated with cisplatin-based chemoradiation. Methods A single center retrospective three to one controlled study in HNSCC patients treated at a single academic health center between January 1st 2015 to December 31st 2021. Patients treated with cisplatin based chemoradiation regimen at a dose of either 40 mg/m2 weekly, or 100 mg/m2 every 3 weeks for a total of 7 weeks were identified and were divided into two cohorts; Cohort A with patients who received concomitant metformin therapy, where concomitant is defined as taken prior to the time of cisplatin start and continued during treatment. And cohort B with a control group of patients who did not receive metformin during cisplatin treatment. Results 18 patients were enrolled retrospectively in cohort A and 54 in cohort B. Our data shows a lower incidence of nephrotoxicity than reported in historical controls. However, no statistically significant differences were identified in direct comparison between the two cohorts. Conclusion Our data reaffirms the higher risk of nephrotoxicity for patients on Q3weeks regimen compared to weekly regimen, however, we were unable to show a statistically significant effect in direct comparison between the cohorts due to sample size limitation.