Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer

Since multiple reports established an association between diabetes mellitus and various cancers, emerging studies have surfaced to understand the effects of metformin as an anti-cancer agent. Although there was previous, but conflicting evidence, of a relationship between diabetes and ovarian cancer...

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Main Authors: Santosh Kumar Singh, Tejumola Apata, Shriti Singh, Melayshia McFadden, Rajesh Singh
Format: Article
Language:English
Published: MDPI AG 2021-08-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/9/8/1020
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author Santosh Kumar Singh
Tejumola Apata
Shriti Singh
Melayshia McFadden
Rajesh Singh
author_facet Santosh Kumar Singh
Tejumola Apata
Shriti Singh
Melayshia McFadden
Rajesh Singh
author_sort Santosh Kumar Singh
collection DOAJ
description Since multiple reports established an association between diabetes mellitus and various cancers, emerging studies have surfaced to understand the effects of metformin as an anti-cancer agent. Although there was previous, but conflicting evidence, of a relationship between diabetes and ovarian cancer (OvCa), recent studies have supported this association. The mechanism of cancer development in patients with diabetes is likely to involve hyperglycemia, hyperinsulinemia, chronic inflammation, reactive oxygen species, regulation of cellular homeostasis, and activation of various pathways that lead to tumor cell proliferation. Preclinical evidence indicating that metformin, a medication commonly used to treat type 2 diabetes mellitus, may protect against OvCa. Metformin exerts anti-cancer properties by activating the MAPK pathway, inhibiting the PI3K/AKT/mTOR pathway, increasing tumor suppressor genes, inducing G2/M cycle arrest, and various other processes. Several studies have shown the efficacy of metformin as an adjunct with standard chemotherapeutic agents due to its synergistic effects on OvCa cells. This review highlights the epidemiologic evidence supporting a link between diabetes and OvCa, the fundamental molecular mechanism underlying carcinogenesis in patients with diabetes, the anti-cancer effects of metformin, and the need for further clinical investigations on combination therapies with metformin and standard chemotherapeutic agents for OvCa.
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spelling doaj.art-aecaf7439a114d4c9b7087417feef7912023-11-22T06:53:27ZengMDPI AGBiomedicines2227-90592021-08-0198102010.3390/biomedicines9081020Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian CancerSantosh Kumar Singh0Tejumola Apata1Shriti Singh2Melayshia McFadden3Rajesh Singh4Department of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USADepartment of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USADepartment of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, IndiaDepartment of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USADepartment of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USASince multiple reports established an association between diabetes mellitus and various cancers, emerging studies have surfaced to understand the effects of metformin as an anti-cancer agent. Although there was previous, but conflicting evidence, of a relationship between diabetes and ovarian cancer (OvCa), recent studies have supported this association. The mechanism of cancer development in patients with diabetes is likely to involve hyperglycemia, hyperinsulinemia, chronic inflammation, reactive oxygen species, regulation of cellular homeostasis, and activation of various pathways that lead to tumor cell proliferation. Preclinical evidence indicating that metformin, a medication commonly used to treat type 2 diabetes mellitus, may protect against OvCa. Metformin exerts anti-cancer properties by activating the MAPK pathway, inhibiting the PI3K/AKT/mTOR pathway, increasing tumor suppressor genes, inducing G2/M cycle arrest, and various other processes. Several studies have shown the efficacy of metformin as an adjunct with standard chemotherapeutic agents due to its synergistic effects on OvCa cells. This review highlights the epidemiologic evidence supporting a link between diabetes and OvCa, the fundamental molecular mechanism underlying carcinogenesis in patients with diabetes, the anti-cancer effects of metformin, and the need for further clinical investigations on combination therapies with metformin and standard chemotherapeutic agents for OvCa.https://www.mdpi.com/2227-9059/9/8/1020metformindiabetes mellitusovarian cancer
spellingShingle Santosh Kumar Singh
Tejumola Apata
Shriti Singh
Melayshia McFadden
Rajesh Singh
Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer
Biomedicines
metformin
diabetes mellitus
ovarian cancer
title Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer
title_full Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer
title_fullStr Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer
title_full_unstemmed Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer
title_short Clinical Implication of Metformin in Relation to Diabetes Mellitus and Ovarian Cancer
title_sort clinical implication of metformin in relation to diabetes mellitus and ovarian cancer
topic metformin
diabetes mellitus
ovarian cancer
url https://www.mdpi.com/2227-9059/9/8/1020
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