Metformin, is one of the medications Diabetes Mellitus (DM) type 2, lately, through several pre-clinical studies are known to have anti-tumor effects. Metformin is the drug of first choice for all patients as DM therapy, unless contraindicated. It turned out that besides the drug is economical drug is also known to have diverse effects pleiotropik, one of which is as anti-cancer properties. As written in the Journal of Clinical Oncology, published in 2009 by Pamela J. Goodwin.
Nevertheless anti-tumor mechanism of metformin is not known with certainty. Several hypothesis: through activation of AMP kinase pathway (AMPK), which is a sensor of cellular energy and potentially a pathway
cancer development. Reduce insulin resistance, where insulin is seen is a growth factor for cancer or cause changes in levels of insulin-like growth factor, sex hormones, and adipokines that contribute to tumorigenesis. Metformin reduces insulin levels by 22% in non-DM women hyperinsulinemia. Overall, metformin has the potential to affect the growth of cancer cells through an indirect mechanism (insulin-mediated) as well as directly affect the proliferation and apoptosis of cancer cells.
An animal studies conducted to show that low-dose metformin inhibits transformation of cells and selectively kill cancer stem cells in four types of breast cancer cells are genetically different. Metformin combination with doxorubicin to kill cancer stem cell visible and non-cancer stem cells in cell culture, reducing the tumor mass, and preventing relapse in a mouse xenograft model.
Currently being planned Phase III clinical trials that assess the effect of metformin therapy on the outcome of breast cancer patients who received adjuvant chemotherapy (including recurrence and mortality).
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