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Background: Cervical cancer is one of the most common gynecological malignancies worldwide including Indonesia which leads to high morbidity and mortality rate. Cisplatin is the first line chemotherapy for treating cervical cancer, but its use is limited because of serious side effects. Our previous study showed that metformin enhanced the anti-proliferative effect of cisplatin in cervical cancer cell line (HeLa). This study aimed to investigate whether or not HeLa cells treated with metformin and cisplatin enhances cell apoptosis. Methods: HeLa cells were cultured with DMEM medium for 24 hours and then treated with either 60 mM metformin, 40 μM cisplatin, a combination of 30 mM metformin and 6.25 μM cisplatin or 7.5 mM metformin and 12.5 μM cisplatin for 48 hours. Apoptotic and necrotic cells were measured using flow cytometer. Data were analyzed using Kruskal-Wallis test, and the significant value was set up at p < 0.05. Results: As compared to control group, HeLa cells treated with 30 mM metformin and 6.25 μM cisplatin had higher apoptosis than cells treated with 7.5 mM metformin and 12.5 μM cisplatin. However, apoptosis induction by metformin and cisplatin combination was much lower than that of 60 mM metformin or 40 μM cisplatin alone. Conclusion: In conclusion, administration of 30 mM metformin and 6.25 μM cisplatin induces higher apoptosis than that of 7.5 mM metformin and 12.5 μM cisplatin in HeLa cells.

Combination of high dose of metformin and low dose of cisplatin increases apoptosis in cervical cancer cells line