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J Endocrinol Invest. 2012 Feb;35(2):231-5.

Does use of metformin protect against cancer in Type 2 diabetes mellitus?

Author information

1
Department of Internal Medicine, University of Turin, Italy. sbo@molinette.piemonte.it

Abstract

BACKGROUND:

Type 2 diabetes mellitus has been associated with an increased cancer risk, which can be modified by specific hypoglycemic drugs. In particular, metformin, the most frequently prescribed biguanide, is now considered a protective agent against cancer incidence and mortality in Type 2 diabetic patients.

AIMS:

To review the potential associations between metformin use and cancer incidence and mortality and the possible biological links implicated in these associations.

MATERIALS AND METHODS:

We searched English-language original investigations published through September 2011.

RESULTS:

Metformin could block the mitogenic effects of insulin, but this effect does not entirely explain the reduction in cancer incidence. Metformin also plays a direct inhibition of cancer cell growth via the inhibitory effects of AMP-activated protein kinase on the mTOR pathway, which regulates cell growth and proliferation. Accordingly, many epidemiological studies have shown that metformin use is associated with a lower cancer incidence and mortality through a dose-response relationship, with greater exposure being associated with stronger risk reduction. Randomized clinical trials testing the effects of metformin on both recurrence and survival in early-stage breast cancer are on-going; these trials are based on pilot studies demonstrating an adjuvant effect of this drug in breast cancer.

CONCLUSIONS:

Metformin is an inexpensive and safe drug, that may modify the increased cancer risk of Type 2 diabetic patients. On-going clinical trials will show whether this drug can enhance the effect of chemotherapy in the treatment of cancer.

PMID:
22490993
DOI:
10.1007/BF03345423
[Indexed for MEDLINE]
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