A Narrative Review: Repurposing Metformin as a Potential Therapeutic Agent for Oral Cancer

Area of Science:

• Oncology
• Endocrinology
• Pharmacology

Background:

• Oral squamous cell carcinoma (OSCC) presents a significant global health burden with limited treatment options.
• Diabetes mellitus (DM) is increasingly associated with oral cancer risk.
• Metformin, a common antidiabetic medication, is being investigated for its potential anticancer properties.

Purpose of the Study:

• To review preclinical and clinical evidence on metformin's mechanisms of action against oral cancer.
• To explore metformin's potential to inhibit OSCC proliferation, induce apoptosis, and enhance current treatments.
• To assess metformin's role in managing head and neck squamous cell carcinoma (HNSCC).

Main Methods:

• Review of preclinical studies examining metformin's effects on metabolic pathways, inflammation, and cell proliferation.
• Analysis of experimental models investigating metformin's impact on epithelial-to-mesenchymal transition (EMT) and the LIN28/let-7 axis.
• Evaluation of clinical studies assessing metformin's efficacy in improving therapeutic outcomes and reducing recurrence rates in cancer patients.

Main Results:

• Preclinical data indicate metformin modulates key metabolic pathways, reduces inflammation, and inhibits cancer cell proliferation.
• Metformin demonstrates potential in reversing EMT and regulating the LIN28/let-7 axis in experimental models.
• Clinical findings suggest metformin can enhance treatment efficacy and lower recurrence rates, despite challenges like drug interactions and vitamin B12 deficiency.

Conclusions:

• Metformin exhibits multifaceted anticancer effects, including antiproliferative and pro-apoptotic activities, relevant to OSCC.
• The drug shows promise in improving outcomes for head and neck cancers, warranting further investigation.
• Optimizing metformin's application, exploring synergistic therapies, and conducting robust clinical trials are crucial for its integration into oral cancer treatment strategies.