Effects of metformin on cancers in experimental and clinical studies:
Focusing on autophagy and AMPK/mTOR Signaling Pathways
Abstract
Metformin (MET) is a preferred drug for the treatment of type 2 diabetes
mellitus. Recent studies show that apart from its blood glucose-lowering
effects, it also inhibits the development of various tumours, by
inducing autophagy. Various studies have confirmed the inhibitory
effects of MET on cancer cell lines’ propagation, migration, and
invasion. The objective of the study was to comprehensively review the
potential of MET as an anticancer agent, particularly focusing on its
ability to induce autophagy and inhibit the development and progression
of various tumors. The study aimed to explore the inhibitory effects of
MET on cancer cell proliferation, migration, and invasion, and its
impact on key signaling pathways such as AMPK, mTOR, and PI3K. This
review noted that MET exerts its anticancer effects by regulating key
signalling pathways such as phosphoinositide 3-kinase (PI3K), LC3-I and
LC3-II, Beclin-1, p53, and the autophagy-related gene (ATG), inhibiting
the mTOR protein, downregulating the expression of p62/SQSTM1, and
blockage of the cell cycle at the G0/G1. Moreover, MET can stimulate
autophagy through pathways associated with the 5′ adenosine
monophosphate-activated protein kinase (AMPK), thereby inhibiting he
development and progression of various human cancers, including
hepatocellular carcinoma, prostate cancer, pancreatic cancer,
osteosarcoma, myeloma, and non-small cell lung cancer. In summary, this
detailed review provides a framework for further investigations that may
appraise the autophagy-induced anticancer potential of MET and its
repurposing for cancer treatment.