The latest breast cancer clinical trials and Metformin

Epithelial malignancies of the breast are the most common cause of cancer (excluding skin cancer) and account for about one-third of all cancers in women. By ۲۰۲۲, approximately ۲.۳ million women worldwide were diagnosed with breast cancer, and ۶۷۰,۰۰۰ lost their lives to it. This means that every ۱۴ seconds, a woman somewhere in the world is diagnosed with breast cancer. On the other hand, type ۲ diabetes (T۲D) accounts for nearly ۹۸% of global diabetes diagnoses, with an expected increase to ۲۶.۶ million cases by ۲۰۲۵. This ratio varies across different countries. Comprehensive meta-analyses conducted over several years have estimated the prevalence of type ۲ diabetes in Iran at ۱۰.۸%. Individuals with T۲D are at a higher risk of developing various malignancies, including breast cancer, with evidence suggesting that T۲D increases the incidence of breast cancer by ۱۰ to ۲۰%. To manage T۲D, metformin is prescribed, which is a biguanide and an oral anti-diabetic medication. This drug has been shown to reduce endothelial dysfunction and exert anti-cancer effects through its impact on various molecular pathways, including the AMP-activated protein kinase (AMPK) pathway and AMPK-independent pathways. In ۲۰۰۵, researchers found that T۲D patients treated with metformin had a lower risk of developing cancer. This finding suggests that metformin may possess anti-tumor properties. Several studies have reinforced the connection between breast cancer risk and T۲D. Epidemiological data and preclinical studies in cultured breast cancer cells and animal models have indicated that metformin may serve as a breast cancer drug, as epidemiological data show a reduced incidence of breast cancer in patients treated with metformin. The anti-cancer and preventive effects of metformin relate to its ability to target physiological disturbances associated with metabolic syndrome, such as its capacity to lower insulin and blood glucose levels, particularly in malignancies linked to hyperinsulinemia. The underlying mechanism may involve limiting tumor cell proliferation alongside reducing the insulin-IGF-۱ axis. The aim of this review is to examine the mechanisms of action of metformin and its clinical relevance to breast cancer.

کلیدواژه ها:

Breast Cancer ، Metformin ، Type ۲ diabetes