揭示SGLT-2抑制剂的抗癌潜力:临床肿瘤学中的机制与前景——一篇叙述性综述

Unveiling the anticancer potential of SGLT-2 inhibitors: mechanisms and prospects in clinical oncology-a narrative review.

作者信息

Li Jiaxin, Qiao Jie, Zhang Shitong, Zhong Jianhua, Ke Caiying, Lin Yiqi, Li Yuetong, Jin Ying, Yao Yaqi, Zhai Aixia, Bi Changlong

机构信息

Department of Endocrinology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.

Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.

出版信息

Eur J Med Res. 2025 Jun 24;30(1):520. doi: 10.1186/s40001-025-02749-3.

Abstract

In recent years, cancer has become more prevalent among younger populations, increasing the burden on public health and the economy. Current cancer treatments are often costly and have long trial periods. Sodium-glucose cotransporter-2 inhibitors (SGLT-2is), including dapagliflozin and canagliflozin, were originally developed for blood glucose control, but have shown promise in anticancer applications. These inhibitors work by inhibiting glucose uptake in tumor cells, thus limiting the energy supply needed for tumor growth. For instance, in lung and hepatocellular cancers, SGLT-2is have been demonstrated to reduce tumor volume and suppress metastasis by modulating key signaling pathways, such as AMPK/mTOR and HIF-1α. Additionally, their ability to enhance the efficacy of chemotherapy and immunotherapy further underscores their potential in cancer treatment. Numerous studies have been conducted on this topic. Diabetes mellitus (DM) is increasingly affecting younger populations and overlaps significantly with cancer. DM patients face higher cancer risks, particularly for liver, colorectal, and pancreatic cancers, with studies indicating up to a 20% increased risk. This highlights the need to consider both conditions in treatment strategies and understand the mechanisms linking DM and cancer to improve outcomes. This study explores the relationship between SGLT-2is and cancer, focusing on their mechanisms in various tumor types and their synergistic effects in combination with other therapies. In the current study, we determined the relationship between SGLT-2is and cancer, and elaborated on the role and mechanisms of SGLT-2is in tumors at different primary sites. In addition, we introduced the anti-tumor effects of SGLT-2is in combination with other means and the underlying mechanisms. From the single-operator to combined-operator level, we reveal the prospects of SGLT-2is in clinical oncology and the future outlook.

摘要

近年来,癌症在年轻人群中变得更加普遍,增加了公共卫生和经济负担。目前的癌症治疗通常成本高昂且试验期长。钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2i),包括达格列净和卡格列净,最初是为控制血糖而开发的,但在抗癌应用中显示出了前景。这些抑制剂通过抑制肿瘤细胞对葡萄糖的摄取来发挥作用,从而限制肿瘤生长所需的能量供应。例如,在肺癌和肝细胞癌中,已证明SGLT-2i通过调节关键信号通路,如AMPK/mTOR和HIF-1α,来减少肿瘤体积并抑制转移。此外,它们增强化疗和免疫治疗疗效的能力进一步凸显了其在癌症治疗中的潜力。关于这个主题已经进行了大量研究。糖尿病(DM)对年轻人群的影响越来越大,且与癌症有显著重叠。糖尿病患者面临更高的癌症风险,尤其是肝癌、结直肠癌和胰腺癌,研究表明风险增加高达20%。这突出了在治疗策略中同时考虑这两种疾病的必要性,并理解将糖尿病和癌症联系起来的机制以改善治疗结果。本研究探讨了SGLT-2i与癌症之间的关系,重点关注它们在各种肿瘤类型中的作用机制以及与其他疗法联合使用时的协同效应。在本研究中,我们确定了SGLT-2i与癌症之间的关系,并阐述了SGLT-2i在不同原发部位肿瘤中的作用和机制。此外,我们介绍了SGLT-2i与其他方法联合使用时的抗肿瘤作用及其潜在机制。从单药治疗到联合治疗层面,我们揭示了SGLT-2i在临床肿瘤学中的前景以及未来展望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7a7/12186366/1f9ae05f9aed/40001_2025_2749_Fig1_HTML.jpg

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