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PATIENTS AND METHODS: All enrolled patients were scheduled to receive 2 cycles of induction PC at conventional doses.
Long-term use of inhaled corticosteroids at conventional doses carries a minor risk of adverse effects.
However, it was also reported that TKIs do not fully inhibit HER2 oncogenic function at conventional doses and concentrations [24].
The dose-limiting toxicity of cyclophosphamide at conventional doses is myelosuppression, primarily leukopenia.
Detergent laxatives (eg, docusate) at conventional doses are only stool softeners, and are rarely effective when used alone for patients at the end-of-life.
Olanzapine causes fewer extrapyramidal symptoms than other antipsychotics, 80, 81 and it does not usually cause QTc prolongation at conventional doses.
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The construction of these trials was based on the association of 'major' drugs for breast cancer, i.e. giving a response rate of at least 40% at conventional dose in first metastatic line: one to three major drugs have been associated, also with less effective but highly employed drugs as fluorouracil, cyclophosphamide and methotrexate.
Our observations, however, do not detract from the plausibility of the mechanisms of antineoplastic action of biguanides demonstrated by laboratory models (1– 7, 25, 26) but suggest that these mechanisms do not operate clinically, at least at the conventional doses used in the treatment of type 2 diabetes.
Robinson and colleagues [ 1] compared plasma anti-factor Xa levels after the subcutaneous administration of the LMW heparin enoxaparin at the conventional dose (40 mg) and at increasingly higher doses (up to 70 mg) in intensive care patients.
However, beside the relevance of metformin doses in experimental model and clinical settings, it is conceivable that translational studies should evaluate metformin at conventional antidiabetic doses but also investigate more aggressive dosing to recognize distinct mechanisms of action relevant for antineoplastic activity.
The starting dose for MC is equally empirical with the major proponents commencing clinical or preclinical trials at 10 33% of conventional doses; no further effort to define this dose is made!
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