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二甲双胍对非糖尿病患者口腔鳞状细胞癌缺氧相关基因表达的影响——一项前瞻性机会窗研究

Effect of metformin on hypoxia-associated gene expression in oral cavity squamous cell carcinoma in non-diabetic patients - a prospective window of opportunity study.

作者信息

Mueller Simon A, Elicin Olgun, Monney Bastien, Rau Tilman, Pra Alan Dal, Sachs Ludwig, Ramos Irene Centeno, Vassella Erik, Dammann Florian, Caparrotti Francesca, Limacher Andreas, Nisa Lluís, Dettmer Matthias S, Giger Roland

机构信息

Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.

出版信息

Eur Arch Otorhinolaryngol. 2025 Jun 4. doi: 10.1007/s00405-025-09493-8.

DOI:10.1007/s00405-025-09493-8
PMID:40468055
Abstract

PURPOSE

Research suggests that metformin may reduce tumor hypoxia, rendering it a potential radiosensitizer. This study investigated metformin's effect on hypoxia-associated gene expression in oral cavity squamous cell carcinoma (OCSCC).

METHODS

In this prospective trial, non-diabetic patients with OCSCC scheduled for curative surgery received preoperative metformin for 10 to 14 days. Tumor biopsies were taken before and after metformin treatment. Gene expression profiling was performed using RNASeq, emphasizing on hypoxia-associated signaling pathways.

RESULTS

Fifteen patients of 25 enrolled patients completed the study protocol and passed quality checks. No significant difference in gene expression was observed after adjustment for multiple testing. No significant changes were found in the hypoxia-associated hypoxia-inducible factor 1- alpha (HIF1A) pathway or in other signaling pathways associated with metformin reported in the literature.

CONCLUSION

This study does not support the hypothesis that metformin improves tumor hypoxia in OCSCC after 10 to 14 days of treatment.

摘要

目的

研究表明二甲双胍可能会减轻肿瘤缺氧状况,使其成为一种潜在的放射增敏剂。本研究调查了二甲双胍对口腔鳞状细胞癌(OCSCC)中缺氧相关基因表达的影响。

方法

在这项前瞻性试验中,计划接受根治性手术的非糖尿病OCSCC患者术前服用二甲双胍10至14天。在二甲双胍治疗前后进行肿瘤活检。使用RNA测序进行基因表达谱分析,重点关注缺氧相关信号通路。

结果

25名入组患者中有15名完成了研究方案并通过了质量检查。在进行多重检验校正后,未观察到基因表达有显著差异。在缺氧相关的缺氧诱导因子1-α(HIF1A)通路或文献中报道的与二甲双胍相关的其他信号通路中未发现显著变化。

结论

本研究不支持二甲双胍在治疗10至14天后可改善OCSCC肿瘤缺氧状况这一假设。

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本文引用的文献

1
Phase I / II trial of metformin as a chemo-radiosensitizer in a head and neck cancer patient population.头颈部癌患者人群中二甲双胍作为化疗增敏剂的 I/II 期试验。
Oral Oncol. 2023 Oct;145:106536. doi: 10.1016/j.oraloncology.2023.106536. Epub 2023 Aug 8.
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Metformin and cancer hallmarks: shedding new lights on therapeutic repurposing.二甲双胍与癌症特征:为治疗用途再开发提供新的见解。
J Transl Med. 2023 Jun 21;21(1):403. doi: 10.1186/s12967-023-04263-8.
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Metformin increases natural killer cell functions in head and neck squamous cell carcinoma through CXCL1 inhibition.
二甲双胍通过抑制 CXCL1 增加头颈部鳞状细胞癌自然杀伤细胞的功能。
J Immunother Cancer. 2022 Nov;10(11). doi: 10.1136/jitc-2022-005632.
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KEGG for taxonomy-based analysis of pathways and genomes.KEGG 用于基于分类的途径和基因组分析。
Nucleic Acids Res. 2023 Jan 6;51(D1):D587-D592. doi: 10.1093/nar/gkac963.
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A Phase II Randomized Trial of Chemoradiation with or without Metformin in Locally Advanced Cervical Cancer.一项关于局部晚期宫颈癌接受放化疗联合或不联合二甲双胍的II期随机试验。
Clin Cancer Res. 2022 Dec 15;28(24):5263-5271. doi: 10.1158/1078-0432.CCR-22-1665.
6
Survival Benefit of Metformin as an Adjuvant Treatment for Head and Neck Cancer: A Systematic Review and Meta-Analysis.二甲双胍作为头颈癌辅助治疗的生存获益:一项系统评价和荟萃分析
Front Pharmacol. 2022 May 13;13:850750. doi: 10.3389/fphar.2022.850750. eCollection 2022.
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Ensembl 2022.Ensembl 2022.
Nucleic Acids Res. 2022 Jan 7;50(D1):D988-D995. doi: 10.1093/nar/gkab1049.
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Why De-Intensification is not Possible in HPV-Associated Cervical Cancer.
Semin Radiat Oncol. 2021 Oct;31(4):339-348. doi: 10.1016/j.semradonc.2021.06.001.
9
Inhibition of mTOR signaling and clinical activity of metformin in oral premalignant lesions.雷帕霉素靶蛋白信号通路抑制和二甲双胍在口腔癌前病变中的临床活性。
JCI Insight. 2021 Sep 8;6(17):e147096. doi: 10.1172/jci.insight.147096.
10
Metformin generates profound alterations in systemic and tumor immunity with associated antitumor effects.二甲双胍可引起全身和肿瘤免疫的深刻改变,并具有相关的抗肿瘤作用。
J Immunother Cancer. 2021 Jul;9(7). doi: 10.1136/jitc-2021-002773.