Will metformin use lead to a decreased risk of thyroid cancer? A systematic review and meta-analyses

Li, Hailong; Chen, Yue; Hu, Lei; Yang, Wenzhi; Gao, Zongshi; Liu, Mengqing; Tao, Hui; Li, Jie

doi:10.1186/s40001-023-01287-0

Cited by 3 publications

(1 citation statement)

References 85 publications

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“…201 Consistent with these findings, a metaanalysis revealed a 45% risk reduction in thyroid cancer among metformin users in Eastern countries, a phenomenon which was more evident in Asian populations than their Western counterparts. 202 Another extensive meta-analysis ascertained a notably lower gynecological cancer occurrence in those undergoing metformin treatment compared to alternative therapies (gynecological cancer: HR = 0.60, 95% CI: 0.49-0.74; endometrial cancer: HR = 0.65, 95% CI: 0.50-0.85; ovarian cancer: HR = 0.47, 95% CI: 0.27-0.82). 203 Thus, metformin has emerged as a paradigm of successful drug repurposing for oncological applications.…”

Section: Dna Damage Responsementioning

confidence: 99%

Drug repurposing for cancer therapy

Xia,

Sun,

Huang

et al. 2024

Sig Transduct Target Ther

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Cancer, a complex and multifactorial disease, presents a significant challenge to global health. Despite significant advances in surgical, radiotherapeutic and immunological approaches, which have improved cancer treatment outcomes, drug therapy continues to serve as a key therapeutic strategy. However, the clinical efficacy of drug therapy is often constrained by drug resistance and severe toxic side effects, and thus there remains a critical need to develop novel cancer therapeutics. One promising strategy that has received widespread attention in recent years is drug repurposing: the identification of new applications for existing, clinically approved drugs. Drug repurposing possesses several inherent advantages in the context of cancer treatment since repurposed drugs are typically cost-effective, proven to be safe, and can significantly expedite the drug development process due to their already established safety profiles. In light of this, the present review offers a comprehensive overview of the various methods employed in drug repurposing, specifically focusing on the repurposing of drugs to treat cancer. We describe the antitumor properties of candidate drugs, and discuss in detail how they target both the hallmarks of cancer in tumor cells and the surrounding tumor microenvironment. In addition, we examine the innovative strategy of integrating drug repurposing with nanotechnology to enhance topical drug delivery. We also emphasize the critical role that repurposed drugs can play when used as part of a combination therapy regimen. To conclude, we outline the challenges associated with repurposing drugs and consider the future prospects of these repurposed drugs transitioning into clinical application.

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Section: Dna Damage Responsementioning

confidence: 99%

Drug repurposing for cancer therapy

Xia,

Sun,

Huang

et al. 2024

Sig Transduct Target Ther

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The Interplay Between High Cumulative Doses of Radioactive Iodine and Type 2 Diabetes Mellitus: A Complex Cardiovascular Challenge

Stanciu,

Bolovan,

Zamfir-Chiru-Anton

et al. 2024

IJMS

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Starting from the metabolic profile of type 2 diabetes mellitus (T2DM), we hypothesized that the mechanisms of ¹³¹I-induced cardiotoxicity differ between patients diagnosed with differentiated thyroid cancer (DTC) with/without T2DM, with metformin potentially acting as a cardioprotective agent by mitigating inflammation in patients with T2DM. To address this hypothesis, we quantified, using ELISA, the serum concentration of several key biomarkers that reflect cardiac injury (NT-proBNP, NT-proANP, ST2/IL-33R, and cTn I) in 74 female patients with DTC/−T2DM and 25 with DTC/+T2DM treated with metformin. All patients received a cumulative oral dose of 131I exceeding 150 mCi (5.55 GBq) over approximately 53 months. Our results showed the following: (i) In DTC/−T2DM patients, high-cumulative 131I doses promote a pro-inflammatory state that accelerates the development of cardiotoxicity. Monitoring NT-proBNP, ST2/IL-33R, and cTn I in these patients may help identify those at risk of developing cardiac complications. (ii) In patients with DTC/+T2DM, high-cumulative 131I doses lead to the release of NT-proANP (r = 0.63), which signals that the atria are under significant stress. (iii) In patients with DTC/+T2DM, metformin suppresses inflammation, leading to a dose-dependent reduction in cTn I (r = −0.59). Monitoring cTn I and NT-proANP, and considering the use of metformin as part of the therapeutic strategy, could help manage cardiotoxicity in T2DM patients undergoing 131I therapy.

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Changes in parameters of carbohydrate metabolism over the course of antitumor treatment with metformin in patients with papillary thyroid cancer

Pidchenko,

Vasylyev,

Astapieva

2023

УРОЖ

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Background. Recently, the incidence of thyroid cancer, namely, its most common histological subtype, papillary thyroid cancer (PTC), has increased. One of the signs of malignant cells of the thyroid is an accelerated metabolism and an increased glucose absorption, which is a source of energy for malignant cells and their growth. Metformin is an insulin sensitizer, and this is the reason why it is used as a potential anticancer drug. The purpose of the work is to analyze changes in parameters of carbohydrate metabolism in patients with PTC over the course of the combined antitumor treatment with metformin depending on the initial level of insulin resistance. Materials and methods. We studied treatment data of 77 patients with PTC who were prescribed 2 courses of radioactive iodine therapy. The patients were divided according to morphological signs: encapsulated cancer (group 1); non-encapsulated cancer (group 2); metastatic lesion (group 3). Also, the analysis of the following factors was performed: sex, age, extent of surgery, stage according to TNM classification, tumor size, presence of metastases, their number and size, level of invasion of cancer (capsule). We measured anthropometric parameters of patients and calculated BMI. The degree of insulin resistance was assessed according to the HOMA-IR index. Results. During the second course of radioactive iodine therapy, insulin level in PTC patients without insulin resistance (IR) increased by 1,23 times in group 1, by 1,44 times in group 2, and by 1,48 times in group 3. We observed an increase in C-peptide values by 1,1 times (5–10%) among the groups. Before the second course of radioactive iodine therapy, the HOMA-IR index increased by 1,33 times in group 1, by 1,46 times in group 2, and by 1,45 times in group 3. During the first and second courses, its value was higher in groups with more aggressive cancer (groups 2 and 3). In group of PTC patients with IR who received metformin, we observed a decrease in insulin level by 1,4 times in group 1 and by 1,5–1,7 times in groups 2 and 3. A similar change can be noted when analyzing C-peptide level. The level of glycated hemoglobin increased by 1,2 times before the second course of radioactive iodine therapy only in groups 2 and 3. However, metformin intake reduced it below the baseline level in all groups of patients. Conclusions. An increase in levels of insulin, C-peptide, and HOMA-IR index was observed in PTC patients without IR after antitumor treatment, especially during the second course of radioactive iodine therapy. A significant increase in the HOMA-IR index by 1,3–1,5 times (t < 1,96) was observed in all PTC patients without IR over the course of antitumor treatment between the first and second courses of radioactive iodine therapy, which is indicative of an increase in insulin resistance, therefore it requires corrective therapy. It is especially observed in groups of patients with more aggressive forms of tumor. Adding metformin led to normalization of the value of this parameter by decreasing it by 1,5 times in all PTC patients with IR regardless of the tumor stage. Inclusion of metformin in the antitumor treatment regimen also contributed to normalization of carbohydrate metabolism. papillary thyroid cancer, HOMA-IR, BMI, carbohydrate metabolism, antitumor treatment, metformin. Для цитування: Підченко Н.С., Васильєв Л.Я., Астап’єва О.М. Показники вуглеводного обміну у динаміці протипухлинного лікування з використанням метформіну у хворих на папілярний рак щитоподібної залози. Український радіологічний та онкологічний журнал. 2023. Т. 31. № 4. С. 285–302. DOI: https://doi.org/10.46879/ukroj.4.2023.285-302 глікованого гемоглобіну збільшуються у 1,2 рази перед 2-м курсом РЙТ тільки у 2-й та 3-й групах, однак, прийом метформіну зменшує їх нижче за вихідний рівень у всіх групах пацієнтів. Висновки. У хворих на ПРЩЗ без ІР на тлі проведеного протипухлинного лікування спостерігалось збільшення рівнів інсуліну, С-пептиду та індексу HOMA-IR, особливо на етапі другого курсу радіойодотерапії. Достовірне збільшення індексу HOMA-IR для всіх хворих на папілярний рак ЩЗ без інсулінорезистентності у 1,3–1,5 рази (t < 1,96) спостерігається в динаміці протипухлинного лікування між першим та другим курсами радіойодотерапії, що свідчить про наростання ІР та потребує корегуючої терапії. Особливо це спостерігається в групах хворих з більш агресивними формами пухлини. У всіх хворих на ПРЩЗ з ІР додавання метформіну сприяло нормалізації рівня цього показника, знижуючи його в 1,5 рази незалежно від ступеня пухлинної агресії. Додавання до схеми протипухлинного лікування метформіну впливало на нормалізацію вуглеводного обміну.

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Will metformin use lead to a decreased risk of thyroid cancer? A systematic review and meta-analyses

Cited by 3 publications

References 85 publications

Drug repurposing for cancer therapy

Drug repurposing for cancer therapy

The Interplay Between High Cumulative Doses of Radioactive Iodine and Type 2 Diabetes Mellitus: A Complex Cardiovascular Challenge

Changes in parameters of carbohydrate metabolism over the course of antitumor treatment with metformin in patients with papillary thyroid cancer

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