Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.
Biomolecules. 2023 Jan 29;13(2):250. doi: 10.3390/biom13020250.
Hematologic malignancies (HMs) mainly include acute and chronic leukemia, lymphoma, myeloma and other heterogeneous tumors that seriously threaten human life and health. The common effective treatments are radiotherapy, chemotherapy and hematopoietic stem cell transplantation (HSCT), which have limited options and are prone to tumor recurrence and (or) drug resistance. Metformin is the first-line drug for the treatment of type 2 diabetes (T2DM). Recently, studies identified the potential anti-cancer ability of metformin in both T2DM patients and patients that are non-diabetic. The latest epidemiological and preclinical studies suggested a potential benefit of metformin in the prevention and treatment of patients with HM. The mechanism may involve the activation of the adenosine monophosphate-activated protein kinase (AMPK) signaling pathway by metformin as well as other AMPK-independent pathways to exert anti-cancer properties. In addition, combining current conventional anti-cancer drugs with metformin may improve the efficacy and reduce adverse drug reactions. Therefore, metformin can also be used as an adjuvant therapeutic agent for HM. This paper highlights the anti-hyperglycemic effects and potential anti-cancer effects of metformin, and also compiles the in vitro and clinical trials of metformin as an anti-cancer and chemosensitizing agent for the treatment of HM. The need for future research on the use of metformin in the treatment of HM is indicated.
血液系统恶性肿瘤（HMs）主要包括急性和慢性白血病、淋巴瘤、骨髓瘤和其他异质性肿瘤，严重威胁着人类的生命和健康。常见的有效治疗方法包括放疗、化疗和造血干细胞移植（HSCT），但这些方法选择有限，且容易发生肿瘤复发和（或）耐药。二甲双胍是治疗 2 型糖尿病（T2DM）的一线药物。最近的研究发现，二甲双胍在 T2DM 患者和非糖尿病患者中都具有潜在的抗癌能力。最新的流行病学和临床前研究表明，二甲双胍可能对 HM 患者的预防和治疗有益。其机制可能涉及二甲双胍激活腺苷单磷酸激活蛋白激酶（AMPK）信号通路以及其他 AMPK 非依赖性途径发挥抗癌作用。此外，将现有的常规抗癌药物与二甲双胍联合使用可能会提高疗效并减少不良反应。因此，二甲双胍也可用作 HM 的辅助治疗药物。本文重点介绍了二甲双胍的降血糖作用和潜在的抗癌作用，并汇编了二甲双胍作为抗癌和化疗增敏剂治疗 HM 的体外和临床试验。指出了未来研究二甲双胍在 HM 治疗中的应用的必要性。
