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The use of metformin in the treatment of gastrointestinal cancer
Author(s) -
С. М. Ткач
Publication year - 2021
Publication title -
klìnìčna endokrinologìâ ta endokrinna hìrurgìâ
Language(s) - English
Resource type - Journals
eISSN - 2519-2582
pISSN - 1818-1384
DOI - 10.30978/cees-2021-3-60
Subject(s) - metformin , medicine , cancer , hyperinsulinemia , diabetes mellitus , biguanide , metabolic syndrome , insulin , type 2 diabetes mellitus , gastrointestinal cancer , oncology , insulin resistance , bioinformatics , endocrinology , colorectal cancer , biology
Type 2 diabetes mellitus and malignancies have several common risk factors, such as obesity, metabolic syndrome, hyperinsulinemia, and chronic inflammation. Currently these factors are considered as possible mechanisms that increase the risk of the development of malignanttumors, including gastrointestinal cancer. Epidemiological studies and meta-analyses indicate that patients with diabetes have a higher incidence and mortality from malignancies. Metformin is well-known oral hypoglycemic drug that belongs to the biguanide class and is being used to treat diabetes mellitus for almost a century. It has been established that in patients with diabetes mellitus, long-term use of metformin reduces the incidence of tumors and mortality from various cancers. The results of recent studies suggest that metformin may have direct pleiotropic anticancer activity against many tumor cells and their microenvironment. Its potential mechanisms include both insulin-dependent and insulin-independent. Moreover, metformin promotes antitumor immunosuppressive metabolic control of T lymphocytes and cancer cells, it is able to modulate the intestinal microbiota and renders a systemic effect on a body metabolism. The article presents data that reveal possible mechanisms of anticancer action of metformin and justify the use of metformin as a drug that may be useful for the treatment of gastrointestinal cancer. Although most of the clinical trials have retrospective design, they are often limited in time and patient bias, recent data from preclinical studies on the antitumor effects of metformin suggest that its effects on carcinogenesis and gastrointestinal cancer progression need to be further investigated. Future studies should consider the diabetic status, prognostic biomarkers, disease stage, and treatment regimens. Given that metformin is a safe and widely available drug with low cost, the feasibility of further study of its anti-cancer effects is beyond doubt.

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