Efficacy of Metformin as Preventive Treatment in Paclitaxel Induced Peripheral Neuropathy in Breast 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.