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Are metformin-based combination approaches beneficial for non-small cell lung cancer: evidence from experimental and
Anita Thyagarajan1, Vaibhav Gajjar2, Ravi P Sahu3
1Department of Pharmacology and Toxicology, Boonshoft School of Medicine Wright State University, Dayton, OH, 45435, USA. anita.thyagarajan@wright.edu.
Abstract:
Despite having multiple treatment options, the overall outcomes, including the survival rates of non-small cell lung cancer (NSCLC) patients, remain relatively low, indicating the need to explore new approaches to achieve improved therapeutic responses. To that end, repurposed drugs such as metformin have been evaluated against many cancer types, including NSCLC. Metformin, a widely used oral hypoglycemic drug for type 2 diabetes, exhibits anticancer properties and synergy with several standards of care agents. In this review, we provide a comprehensive overview of the role and anticancer mechanisms of metformin-based combination approaches for the treatment of NSCLC. We logically discussed the experimental evidence from the in vitro and in vivo studies utilizing metformin alone, and then its combination with chemotherapeutic agents, targeted therapy, and immunotherapy. We also present clinical trials that underscore the beneficial and adverse outcomes of metformin use in combination with targeted therapy and chemotherapeutic agents, and emphasize the limitations and challenges for the treatment of diabetic and non-diabetic NSCLC patients. It appears that, regardless of the diverse anticancer mechanisms of this biguanide, the benefits may be confined to a specific patient subgroup, which opens new avenues to be explored for NSCLC treatment.
Insights
Metformin shows anticancer properties and may improve outcomes when combined with standard non-small cell lung cancer (NSCLC) treatments. Further research is needed to identify specific patient subgroups who benefit most from this repurposed drug.
Area of Science:
- Oncology
- Pharmacology
- Cancer Therapeutics
Background:
- Non-small cell lung cancer (NSCLC) outcomes remain poor despite available treatments, necessitating novel therapeutic strategies.
- Metformin, a type 2 diabetes drug, exhibits anticancer properties and potential synergy with existing cancer therapies.
Purpose of the Study:
- To comprehensively review the role and anticancer mechanisms of metformin-based combination therapies in NSCLC treatment.
- To evaluate experimental evidence and clinical trial data on metformin's efficacy and safety in NSCLC.
Main Methods:
- Review of in vitro and in vivo studies on metformin alone and in combination with chemotherapy, targeted therapy, and immunotherapy.
- Analysis of clinical trials assessing metformin's benefits and adverse effects in NSCLC patients.
Main Results:
- Metformin demonstrates anticancer properties and potential synergy with standard NSCLC treatments.
- Clinical trials show both beneficial and adverse outcomes of metformin in combination therapies.
- The efficacy of metformin may be limited to specific patient subgroups.
Conclusions:
- Metformin-based combination approaches offer a potential avenue for improving NSCLC treatment outcomes.
- Identifying specific patient subgroups who benefit from metformin is crucial for optimizing its use.
- Further research is warranted to elucidate metformin's mechanisms and refine its application in NSCLC therapy.
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