Cancer Metabolism

Window of opportunity clinical trial designs to study cancer metabolism


Window of opportunity trials exploit the ‘window’ of time after cancer diagnosis, typically prior to initiation of cancer therapy. In recent years this study design has become a more regular feature of drug development, as this ‘window’ provides an opportunity to carry out a thorough pharmacodynamic assessment of a therapy of interest in tumours that are unperturbed by prior treatment. Many of the first window trials interrogated the bioactivity of drugs being repurposed for cancer treatment, in particular the anti-mitochondrial agent, metformin. In this review, we describe examples of window study designs that have been used to assess drugs that target cancer metabolism with a focus on metformin. In addition, we discuss how window studies may aid the development of molecular metabolic cancer imaging.

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F.A. co-wrote the manuscript. S.L. co-wrote and revised the manuscript.

Correspondence to Simon R. Lord.

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S.L. is funded by Oxford Experimental Cancer Medicine Centre and Against Breast Cancer. Funding for the NEOMET, FRONTIER and IMAGO window studies was provided by the Oxford Cancer Imaging Centre (funded by Cancer Research UK and the Engineering and Physical Sciences Research Council) and the NIHR Oxford Biomedical Research Centre.

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Aroldi, F., Lord, S.R. Window of opportunity clinical trial designs to study cancer metabolism. Br J Cancer 122, 45–51 (2020).

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