At present, there are no FDA-approved treatments for chemotherapy-induced neuropathy. Discrete neuro anti-inflammatory effects of metformin support its repurposing as a neuroprotective agent in patients with neurodegenerative diseases. Therefore, this study aims to evaluate the effect of metformin on the amelioration of paclitaxel induced neuropathy in cancer patients.

Inclusion Criteria:

• Adult patients (>18 years old)
• Early-stage breast cancer patients who will receive adjuvant paclitaxel
• Performance status according to Eastern Cooperative oncology group (ECOG) < 2.
• Adequate bone marrow function (white blood count ≥4,000/mm3, platelet count ≥100,000/mm3), liver function (serum total bilirubin <1.5 mg/dl), renal function (creatinine<1.5 mg/dl).

Exclusion Criteria:

• Clinical neuropathy at prior to enrollment.
• Patients treated with medications that increase the risk of neuropathy like amiodarone, Colchicine, metronidazole, phenytoin.
• Patients with a history of hypersensitivity to metformin.
• Pregnant or lactating females.
• Patients who are using metformin for any other cause.
• Patients with Diabetes mellitus.
• Receiving vitamin B1, B6, B12 or another vitamin supplemental therapy.
• Receiving antidepressants, opioids, adjuvant analgesic agents (eg, anticonvulsants, clonazepam, or mexiletine), topical analgesics, and amifostine.