C3 + Gemcitabine for Pancreatic Cancer

(C3 Trial)

This trial explores whether a combination of medications (C3: metformin, simvastatin, and digoxin) with Gemcitabine can safely and effectively treat advanced pancreatic cancer. Researchers aim to determine if this treatment can slow the disease and improve patient longevity. Participants will receive either the combination of C3 and Gemcitabine or just C3 if they cannot take Gemcitabine. Those diagnosed with advanced pancreatic cancer who have tried at least one other treatment without success may be a good fit for this trial. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this innovative combination therapy.

Research has shown that the combination of Metformin, Simvastatin, and Digoxin, known as C3, is generally safe and well-tolerated. Studies indicate that using these three drugs together does not cause serious side effects. Specifically, one study found no major issues when participants took these drugs together for 18 months.

Metformin often treats diabetes, and Simvastatin commonly lowers cholesterol. Both have been used safely by many without major problems.

When combined with Gemcitabine, research found that C3 and Gemcitabine worked better together against pancreatic cancer cells than when used separately. While this doesn't directly address safety, it suggests effective combined use.

Researchers are excited about these treatments because they combine commonly used drugs—metformin, simvastatin, and digoxin—in a novel way to target pancreatic cancer. While standard treatments like chemotherapy (e.g., Gemcitabine alone) primarily attack fast-growing cancer cells, this combination (C3) aims to disrupt cancer cell metabolism and growth through different mechanisms. Metformin is known for its potential anti-cancer effects, simvastatin might inhibit cancer cell proliferation, and digoxin can interfere with cellular signaling. This multi-pronged approach could offer new hope by enhancing the effectiveness of traditional chemotherapy or serving as an alternative for those who can't tolerate it.

This trial will evaluate the combination of metformin, simvastatin, and digoxin (C3) for pancreatic cancer. Studies have shown that this combination can help slow the growth of pancreatic cancer cells. Specifically, simvastatin slows tumor growth, while using metformin and statins together may help patients live longer. Research indicates that metformin use is linked to better overall survival for pancreatic cancer patients, with a 21% lower risk of death compared to those not using it. Additionally, low doses of metformin and simvastatin together have slowed the development of pancreatic cancer, suggesting these drugs are promising for treating this condition. Participants in this trial may receive C3 alone or in combination with Gemcitabine, depending on their treatment arm.¹²³⁴⁶