Background:
Neoadjuvant chemoradiotherapy (nCRT) decreases the risk of local
recurrence after surgery in patients with locally advanced rectal cancer (LARC) and metformin is
constantly gaining scientific interest due to its potentially radiosensitizing effect
Objective:
This review article aims to better clarify the role of metformin as a radiosensitizer in
patients with LARC undergoing neoadjuvant concurrent chemoradiotherapy.
Methods:
We used the PubMed database to retrieve journal articles and the inclusion criteria were
all human studies that illustrated the effective role of metformin in the neoadjuvant setting of
locally advanced rectal cancer
Results:
Our search resulted in 17 citations, of which 10 eventually fulfilled the inclusion criteria
of our study. Promising results (improved tumor and nodal regression as well as higher pathologic
complete response rate) have been occasionally documented with metformin use in some of the
included studies. However, regarding survival and all-cause mortality, no significant difference has
been found
Conclusion:
Metformin might constitute a highly promising radiosensitizer in neoadjuvant LARC
treatment attracting much scientific interest. Due to the lack of studies with high evidence, further
advanced research is required to enhance the existing knowledge about its potential value in this
field