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A Rapid Screening Workflow to Identify Potential Combination Therapy for GBM using Patient-Derived Glioma Stem Cells
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Glucose and antidiabetic therapy in temozolomide resistance in glioblastoma

Emir Begagić1, Amina Džidić-Krivić2, Hakija Bečulić3

  • 1Department of Neurosurgery, Cantonal Hospital Zenica, Zenica 72000, Bosnia and Herzegovina. begagicem@gmail.com.

World Journal of Clinical Oncology
|September 3, 2025
PubMed

Insights

Metformin, an antidiabetic drug, shows potential in treating glioblastoma (GBM) by targeting cancer metabolism and enhancing chemotherapy. Further research is needed to confirm its role as an adjunct therapy for GBM patients.

Area of Science:

  • Oncology
  • Metabolic Medicine
  • Pharmacology

Background:

  • Glioblastoma (GBM) presents significant therapeutic challenges with limited success from standard treatments.
  • Altered glucose metabolism is implicated in GBM development, with hyperglycemia potentially driving cancer progression.
  • Metformin, an antidiabetic drug, has shown preliminary promise in GBM patient survival, possibly due to its blood-brain barrier penetration and metabolic targeting capabilities.

Purpose of the Study:

  • To investigate the therapeutic potential of metformin as an adjunct therapy for glioblastoma.
  • To explore metformin's mechanisms of action in GBM, including its effects on glioma stem cells and chemoresistance.
  • To evaluate ongoing research and novel strategies for optimizing metformin's efficacy in GBM treatment.

Main Methods:

  • Review of preclinical studies investigating metformin's effects on GBM cell lines and animal models.
  • Analysis of early-phase clinical trials assessing metformin's safety and efficacy in GBM patients.
  • Exploration of mechanistic studies examining metformin's impact on cellular pathways like AMPK and Wnt signaling.

Main Results:

  • Preclinical data suggest metformin may enhance temozolomide (TMZ) efficacy by targeting glioma stem cells and overcoming resistance.
  • Metformin's activation of AMPK and modulation of Wnt signaling pathways indicate potential therapeutic benefits.
  • Current clinical evidence on metformin's direct impact on GBM survival remains inconclusive, necessitating further investigation.

Conclusions:

  • Metformin exhibits promising preclinical activity and potential mechanisms for adjunct therapy in glioblastoma.
  • Clarifying metformin's precise role and identifying responsive patient subgroups require ongoing rigorous clinical trials and mechanistic studies.
  • Novel strategies, including advanced drug delivery systems, are being explored to enhance metformin's therapeutic profile in GBM treatment.
Keywords:
Antidiabetic drugsDrug resistanceGlioblastoma multiformeGlucose metabolismNeoplasms

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