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TNBC reoccurrence mets to skin inoperable tumour In right breast and left lymph node involved

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johan
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Effect of metformin on kidney function in patients with type 2 diabetes mellitus and moderate chronic kidney disease https://www.oncotarget.com/article/23387/text/

Conclusions: Metformin may have an adverse effect on renal function in patients with type 2 DM and moderate CKD.

"Most of the lactate removal by the kidneys is through lactate metabolism rather than excretion, and impaired renal function may decrease the ability of the kidneys to metabolize an increase in lactate caused by metformin. "


   
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Chris48
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Posted by: @j

But clearly, it should be used with great caution.

Since Berberine also inhibits Complex I, would you rather go a completely different route and try to avoid anything that inhibits Complex I activity?


   
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johan
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Posted by: @chris48

Posted by: @j

But clearly, it should be used with great caution.

Since Berberine also inhibits Complex I, would you rather go a completely different route and try to avoid anything that inhibits Complex I activity?

That's a great question, Chris. If I'd use niacin and try to enhance complex I, because of its anticancer potential as shown in that study, I'd avoid using berberine and honokiol, so it would depend on what I'm trying to achieve. In my view, Berberine can still be of use in TNBC but in case I'd use it I'd watch it closely, use it in combination with emodin, caffeine, and/or curcumin, and discontinue if I wasn't seeing any good results. I think it's important to be very flexible and have several backup strategies lined up in order to move and adapt quickly. When treatment isn't working it's crucial to change to a new treatment asap, I see people sticking to treatment plans or protocols in spite of lack of improvement, or worse, progression, so basically there hoping it will work eventually but that's not how it works with cancer, at least not in my view. Sometimes dosages need to be adjusted, but when you use a compound that you know could either reduce or promote cancer you need to be extra careful and make choices based on your best options. 

 


   
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johan
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Combination of (−)-Epigallocatechin-3-gallate and Tapentadol

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754998/

"Cell proliferation, viability and apoptosis of MDA-MB-231 cells were impaired by the combination of EGCG and tapentadol. Specifically, our data show that EGCG and TAP reduced the proliferation of MDA-MB-231 cells by impairing cell-cycle progression (p<0.05). These findings suggest that the combination of these substances may represent a new strategy for the treatment of patients suffering from triple-negative breast cancer."


   
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johan
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@chris48 here's a remarkable study that highlights the importance of synergistic combinations, in this case apigenin + metformin, and proper dosage (see the size of the tumors for the varying treatments and dosages)

 


   
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johan
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Posted by: @j

Posted by: @chris48

Posted by: @j

But clearly, it should be used with great caution.

Since Berberine also inhibits Complex I, would you rather go a completely different route and try to avoid anything that inhibits Complex I activity?

That's a great question, Chris. If I'd use niacin and try to enhance complex I, because of its anticancer potential as shown in that study, I'd avoid using berberine and honokiol, so it would depend on what I'm trying to achieve. In my view, Berberine can still be of use in TNBC but in case I'd use it I'd watch it closely, use it in combination with emodin, caffeine, and/or curcumin, and discontinue if I wasn't seeing any good results. I think it's important to be very flexible and have several backup strategies lined up in order to move and adapt quickly. When treatment isn't working it's crucial to change to a new treatment asap, I see people sticking to treatment plans or protocols in spite of lack of improvement, or worse, progression, so basically there hoping it will work eventually but that's not how it works with cancer, at least not in my view. Sometimes dosages need to be adjusted, but when you use a compound that you know could either reduce or promote cancer you need to be extra careful and make choices based on your best options. 

 

@chris46 @jens I've attached a flow chart to illustrate what I've outlined above. It helps to visualize different treatment strategies. In my view, the application of the most effective combination is paramount, the study of metformin + apigenin is a great example of this. Visualizing different strategies based on synergistic effects will help you to quickly adapt and select the best options if needed. 

 


   
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johan
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a few more addition based on synergistic effects. one can expand along this idea of synergies, providing many additional and adjuvant treatment options in case they are needed.


   
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Chris48
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Posted by: @j

a few more addition based on synergistic effects. one can expand along this idea of synergies, providing many additional and adjuvant treatment options in case they are needed.

This is great! Thank you so much, Johan!
Is there a meaning behind the arrows? So e.g. if you are on metformin, apigenin and luteolin, you can either go down the route
"EGCG, tamoxifen, aspirin, vitamin d"
OR
"curcumin, emodin, berberine, zinc"?
Are those 2 seperate synergistic groups that might not even be combined?

 


   
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johan
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Posted by: @chris48

Posted by: @j

a few more addition based on synergistic effects. one can expand along this idea of synergies, providing many additional and adjuvant treatment options in case they are needed.

This is great! Thank you so much, Johan!
Is there a meaning behind the arrows? So e.g. if you are on metformin, apigenin and luteolin, you can either go down the route
"EGCG, tamoxifen, aspirin, vitamin d"
OR
"curcumin, emodin, berberine, zinc"?
Are those 2 seperate synergistic groups that might not even be combined?

 

@chris48 The arrows are synergistic combinations based on studies, mostly in vivo, and some in vitro. 

An arrow indicates synergy between those 2 compounds, most studies are based on the synergy of 2 compounds but if A synergizes with B and B with C I think A, B & C are likely to be a good combination.

Groups of compounds with synergistic effects may be combined if there are no issues with drug interactions, e g. metformin and celecoxib, you´ll notice I've kept them separate. If there are no harmful drug interactions different groups can be combined as these are all anticancer.

If have attached an update of the chart, with a few more options.

 


   
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johan
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in the last diagram, I added some adjuvant strategies based on a hypothesis I have outlined here:

https://synergiesforcancertreatments.blogspot.com/2018/06/the-truth-about-cancer.html

 


   
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johan
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gingerols have anticancer activity in TNBC, the problem is the small amounts of it in ginger, but in combination with anthocyanin, much less is needed to induce anticancer activity:

"dose reduction index (DRI) values of 1.1–3-fold for anthocyanin and 2.2–103-fold for gingerol extracts were observed. This research is the first to reveal the synergistic effects of anthocyanin and gingerol extracts in inhibiting the growth of cancer cells. "

https://pubs.acs.org/doi/abs/10.1021/acsfoodscitech.1c00029


   
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johan
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I´m dropping a link here to the other TNBC threads this way both threads are linked on both ends:

https://www.cancertreatmentsresearch.com/community/breast-cancer/tnbc-testing-strategies-in-a-ned-situation/paged/4/#post-6360


   
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