Metformin Hydrochloride and Doxycycline in Treating Patients With Head and Neck Squamous Cell Carcinoma

Exclusion Criteria

• •1. Subjects that do not have a baseline tumor specimen/biopsy prior to starting study medications.
• •a. Tumor specimens do not need to be at Jefferson at time of eligibility determination. Tumor specimens held at outside institutions should be requested for analysis of pre-treatment tumor vs post-treatment tumor.
• •2. Subjects who are pregnant or breastfeeding, or may become pregnant during metformin and doxycycline administration.
• •3. Received prior cancer therapy for the HNSCC that is being resected.
• •4. Subjects on metformin or doxycycline for any reason during the preceding 4 weeks.
• •5. Diabetic subjects that are managed by taking metformin or insulin
• •6. Subjects who have received iodinated contrast dye must wait 12 hours prior to starting Metformin. If a CT scan with contrast is scheduled after screening and consent, the metformin cannot be taken until after the CT with contrast has been completed and they have waited 12 hours.
• •7. Patients with serum creatine ≥1.5 mg/dL
• •8. Patients with history of lactic or any other metabolic acidosis.
• •9. Patients with history of congestive heart failure stage III or greater.
• •10. Patients scheduled for definitive cancer surgical resection less than 7 days from beginning of study drug administration or greater than 6 weeks from beginning study drug administration.
• •11. Patients with history of hepatic dysfunction or hepatic disease and abnormal liver function tests defined as AST, ALT, Alk Phos, and or total bilirubin greater than 2.5 times the upper limit of normal. Patients who have a history of hepatic dysfunction or hepatic disease and normal liver function tests will be eligible to participate.
• •12. Patients with a current history (in the past 30 days) of heavy drinking which is defined in accordance with CDC definition as more than 8 drinks per week for women and more than 15 drinks per week for men. A standard drink contains .6 ounces of pure alcohol. Generally, this amount of pure alcohol is found in 12-ounces of beer, 8-ounces of malt liquor, 5-ounces of wine, 1.5-ounces or a "shot" of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey). While on study, patients should limit their alcohol consumption to no more than 8 drinks per week for women and no more than 15 drinks per week for men.
• •13. Patient with prior allergic reaction to metformin, doxycycline, or any other tetracycline antibiotic in the past.
• •14. Patient is on medications that are contraindicated with metformin or doxycycline under current FDA recommendations. The following is a list of medications identified as class D (consider therapy modification) when treatment with metformin or doxycycline is considered:
• •* Class D:
• •* Bismuth Subsalicylate
• •* Cimetidine
• •* Iodinated cont