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Exploring the role of metformin in anticancer treatments: a systematic review
V C Miranda1, R Barroso-Sousa1, J Glasberg1
1Departamento de Radiologia e Oncologia, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
Abstract:
Many clinical and preclinical studies suggest that metformin has antitumor activity. There are two main mechanisms that justify this effect: its ability to activate AMPK, preventing the gluconeogenesis in the liver and stimulating glucose uptake in muscle (insulin-independent), and its potential to negatively regulate mTOR activity (insulin- dependent). Thus, numerous studies have evaluated its role in cancer risk, prognosis and as an antitumor therapy in different malignancies. The following is a systematic review on the clinical evidence about the effects of metformin in cancer. Uncontrolled studies suggest that metformin is associated with reduced risk of different types of cancers among patients with hyperinsulinemia conditions, such as diabetes and obesity. However, among cancer patients, the literature is conflicting about the real impact of metformin on survival and outcomes of cancer treatments. The effects of metformin in nondiabetic patients remain unknown. Ongoing randomized trials are awaited to prove the true antineoplastic activity of metformin.
Insights
Metformin shows potential antitumor activity through AMPK and mTOR pathways. While some studies link it to reduced cancer risk in diabetic or obese patients, its impact on cancer patient outcomes remains unclear, pending further trials.
Area of Science:
- Oncology
- Pharmacology
- Metabolic Diseases
Background:
- Metformin, a common diabetes drug, exhibits potential antitumor properties via AMPK and mTOR signaling pathways.
- Preclinical and clinical studies suggest metformin influences cancer risk and progression.
Purpose of the Study:
- To systematically review clinical evidence on metformin's effects in cancer.
- To evaluate metformin's role in cancer risk, prognosis, and treatment outcomes.
Main Methods:
- Systematic review of clinical studies.
- Analysis of data from uncontrolled studies and ongoing randomized trials.
Main Results:
- Uncontrolled studies suggest metformin may reduce cancer risk in hyperinsulinemic conditions (diabetes, obesity).
- Conflicting literature exists regarding metformin's impact on survival and treatment outcomes in existing cancer patients.
- The effects of metformin in non-diabetic individuals with cancer are largely unknown.
Conclusions:
- Metformin's role in cancer is complex and requires further investigation.
- Evidence suggests a potential benefit in reducing cancer risk for specific patient groups.
- Ongoing randomized trials are crucial to establish metformin's definitive antineoplastic efficacy.
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