Magic of a Common Sugar Pill in Cancer: Can Metformin Raise Survival in Pancreatic Cancer Patients?

Gyawali, Mallika; Venkatesan, Nanditha; Ogeyingbo, Opemipo D; Bhandari, Renu; Botleroo, Rinky A; Kareem, Roaa; Ahmed, Rowan; Elshaikh, Abeer O

doi:10.7759/cureus.16916

Cited by 3 publications

(1 citation statement)

References 36 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Better survival for patients after pancreatectomy [121]; inconsistent results in various studies [122] Inhibited pancreatic tumor development [11] Inhibited proliferation, migration, and invasion; induced G1-phase apoptosis in tumor cells [123]; associated to reduced pancreatic adenocarcinoma risk [124] Cancer specific mortality was found to be lower after the use of beta-blockers in observational studies [19]…”

Section: Pancreasmentioning

confidence: 99%

Antidiabetics, Anthelmintics, Statins, and Beta-Blockers as Co-Adjuvant Drugs in Cancer Therapy

et al. 2022

View full text Add to dashboard Cite

Over the last years, repurposed agents have provided growing evidence of fast implementation in oncology treatment such as certain antimalarial, anthelmintic, antibiotics, anti-inflammatory, antihypertensive, antihyperlipidemic, antidiabetic agents. In this study, the four agents of choice were present in our patients’ daily treatment for nonmalignant-associated pathology and have known, light toxicity profiles. It is quite common for a given patient’s daily administration schedule to include two or three of these drugs for the duration of their treatment. We chose to review the latest literature concerning metformin, employed as a first-line treatment for type 2 diabetes; mebendazole, as an anthelmintic; atorvastatin, as a cholesterol-lowering drug; propranolol, used in cardiovascular diseases as a nonspecific inhibitor of beta-1 and beta-2 adrenergic receptors. At the same time, certain key action mechanisms make them feasible antitumor agents such as for mitochondrial ETC inhibition, activation of the enzyme adenosine monophosphate-activated protein kinase, amelioration of endogenous hyperinsulinemia, inhibition of selective tyrosine kinases (i.e., VEGFR2, TNIK, and BRAF), and mevalonate pathway inhibition. Despite the abundance of results from in vitro and in vivo studies, the only solid data from randomized clinical trials confirm metformin-related oncological benefits for only a small subset of nondiabetic patients with HER2-positive breast cancer and early-stage colorectal cancer. At the same time, clinical studies confirm metformin-related detrimental/lack of an effect for lung, breast, prostate cancer, and glioblastoma. For atorvastatin we see a clinical oncological benefit in patients and head and neck cancer, with a trend towards radioprotection of critical structures, thus supporting the role of atorvastatin as a promising agent for concomitant association with radiotherapy. Propranolol-related increased outcomes were seen in clinical studies in patients with melanoma, breast cancer, and sarcoma.

show abstract

Section: Pancreasmentioning

confidence: 99%

Antidiabetics, Anthelmintics, Statins, and Beta-Blockers as Co-Adjuvant Drugs in Cancer Therapy

et al. 2022

View full text Add to dashboard Cite

show abstract

The Impact of Epithelial–Mesenchymal Transition and Metformin on Pancreatic Cancer Chemoresistance: A Pathway towards Individualized Therapy

et al. 2022

View full text Add to dashboard Cite

Globally, pancreatic ductal adenocarcinoma remains among the most aggressive forms of neoplastic diseases, having a dismal prognostic outcome. Recent findings elucidated that epithelial–mesenchymal transition (EMT) can play an important role in pancreatic tumorigenic processes, as it contributes to the manifestation of malignant proliferative masses, which impede adequate drug delivery. An organized literature search with PubMed, Scopus, Microsoft Academic and the Cochrane library was performed for articles published in English from 2011 to 2021 to review and summarize the latest updates and knowledge on the current understanding of EMT and its implications for tumorigenesis and chemoresistance. Furthermore, in the present paper, we investigate the recent findings on metformin as a possible neoadjuvant chemotherapy agent, which affects EMT progression and potentially provides superior oncological outcomes for PDAC patients. Our main conclusions indicate that selectively suppressing EMT in pancreatic cancer cells has a promising therapeutic utility by selectively targeting the chemotherapy-resistant sub-population of cancer stem cells, inhibiting tumor growth via EMT pathways and thereby improving remission in PDAC patients. Moreover, given that TGF-β1-driven EMT generates the migration of tumor-initiating cells by directly linking the acquisition of abnormal cellular motility with the maintenance of tumor initiating potency, the chemoprevention of TGF-β1-induced EMT may have promising clinical applications in the therapeutic management of PDAC outcomes.

show abstract

Cáncer de páncreas

CORDÓN GRANADOS,

SAURA PARRAMON

2024

AMF

View full text Add to dashboard Cite

Puntos clave El cáncer de páncreas (CP) es un tumor con una gran letalidad y la sintomatología generalmente es muy inespecífica, incluso silente hasta fases avanzadas, lo que provoca retrasos en el diagnóstico. Dada la baja supervivencia, es importante estar alerta ante signos de sospecha y se debe disponer de un circuito de derivación rápida para el diagnóstico precoz y el inicio del tratamiento. El tabaquismo es el factor de riesgo mejor establecido de CP; el riesgo en fumadores se multiplica por dos. Existe cada vez más evidencia de que el consumo elevado de alcohol contribuye al riesgo de CP. El aumento de la esperanza de vida y la creciente incidencia de diabetes y de obesidad hacen prever una creciente tasa de CP en un futuro cercano. El tratamiento quirúrgico y las terapias citotóxicas actualmente disponibles son muy poco efectivas para la enfermedad avanzada.

show abstract

Magic of a Common Sugar Pill in Cancer: Can Metformin Raise Survival in Pancreatic Cancer Patients?

Cited by 3 publications

References 36 publications

Antidiabetics, Anthelmintics, Statins, and Beta-Blockers as Co-Adjuvant Drugs in Cancer Therapy

Antidiabetics, Anthelmintics, Statins, and Beta-Blockers as Co-Adjuvant Drugs in Cancer Therapy

The Impact of Epithelial–Mesenchymal Transition and Metformin on Pancreatic Cancer Chemoresistance: A Pathway towards Individualized Therapy

Cáncer de páncreas

Contact Info

Product

Resources

About