二甲双胍在乳腺癌中抗肿瘤作用研究进展

临床前研究表明降糖药二甲双胍对乳腺癌有抗肿瘤作用，能降低糖尿病患者乳腺癌发病风险和死亡风险，也能提高乳腺癌患者新辅助化疗后病理完全缓解率。体内外实验表明二甲双胍有效抑制各种乳腺癌细胞和移植瘤，并和化疗药物、HER2靶向药物、新型抗肿瘤药物有良好协同作用。主要分子机制包括全身性下调胰岛素及相关信号通路、肿瘤细胞内激活LKBl／AMPK、抑制下游mTOR通路等。目前各国开展了多个临床试验评估--sp双胍在乳腺癌防治中的应用价值。

Anti-tUmor effect of metformin in breast cancer

Recent preclinical data have demonstrated that antidiabetic drug metformin can act as an anticancer agent for breast cancer. Epidemiologic evidences show that metformin decreases the incidence of breast cancer and cancer-related mortality in diabetic patients. The metformin treatment also increases complete patho- logical tumor response rates following neoadjuvant chemotherapy for breast cancer patients. Mefformin also dis- plays significant growth inhibitory effects in most types of breast cancer cell lines and tumor xenografts in mice. Preclinical data also shows metformin combined with chemotherapy drugs or HER2-targeted drugs or new anti- cancer drugs has synergic anti-cancer effect. Reduction of the insulin/insulin-like growth factor signaling path- way in body and activation of LKB1/AMPK and inhibition of downstream mTOR pathway in tumor cells have been found to play the most important role in anti-cancer effect of mefformin. Currently, a number of clinical trials are underway in breast cancer patients to evaluate the effective use value of metformin as a cancer therapy .