Oral cancer, particularly oral squamous cell carcinoma (OSCC), is a significant global health challenge because of its high incidence and limited treatment options. Major risk factors, including tobacco use, alcohol consumption, and specific microbiota, contribute to the disease’s prevalence. Recently, a compelling association between diabetes mellitus (DM) and oral cancer has been identified, with metformin, a widely used antidiabetic drug, emerging as a potential therapeutic agent across various cancers, including OSCC. This review explores both preclinical and clinical studies to understand the mechanisms by which metformin may exert its anticancer effects, such as inhibiting cancer cell proliferation, inducing apoptosis, and enhancing the efficacy of existing treatments. Preclinical studies demonstrate that metformin modulates crucial metabolic pathways, reduces inflammation, and impacts cellular proliferation, thereby potentially lowering cancer risk and improving patient outcomes. Additionally, metformin’s ability to reverse epithelial-to-mesenchymal transition (EMT), regulate the LIN28/let-7 axis, and its therapeutic role in head and neck squamous cell carcinoma (HNSCC) are examined through experimental models. In clinical contexts, metformin shows promise in enhancing therapeutic outcomes and reducing recurrence rates, although challenges such as drug interactions, complex dosing regimens, and risks such as vitamin B12 deficiency remain. Future research should focus on optimizing metformin’s application, investigating its synergistic effects with other therapies, and conducting rigorous clinical trials to validate its efficacy in OSCC treatment. This dual exploration underscores metformin’s potential to play a transformative role in both diabetes management and cancer care, potentially revolutionizing oral cancer treatment strategies.
口腔癌，尤其是口腔鳞状细胞癌（OSCC），因其高发病率和有限的治疗选择，已成为全球性的重大健康挑战。主要风险因素包括烟草使用、饮酒和特定微生物群，这些因素共同导致了该疾病的高发。近年来，糖尿病（DM）与口腔癌之间被证实存在显著关联，而二甲双胍作为一种广泛使用的抗糖尿病药物，已在包括OSCC在内的多种癌症中显示出潜在的治疗价值。本综述通过梳理临床前及临床研究，探讨二甲双胍可能发挥抗癌作用的机制，例如抑制癌细胞增殖、诱导细胞凋亡以及增强现有治疗方法的疗效。临床前研究表明，二甲双胍能够调节关键代谢通路、减轻炎症反应并影响细胞增殖，从而可能降低癌症风险并改善患者预后。此外，通过实验模型研究发现，二甲双胍具有逆转上皮-间质转化（EMT）、调控LIN28/let-7轴的作用，并在头颈部鳞状细胞癌（HNSCC）中展现出治疗潜力。在临床实践中，二甲双胍虽显示出改善治疗效果和降低复发率的潜力，但仍面临药物相互作用、复杂给药方案以及维生素B12缺乏等风险挑战。未来研究应聚焦于优化二甲双胍的应用方案、探索其与其他疗法的协同效应，并通过严谨的临床试验验证其在OSCC治疗中的有效性。这种双重探索突显了二甲双胍在糖尿病管理和癌症治疗领域可能发挥的革命性作用，有望为口腔癌治疗策略带来根本性变革。
A Narrative Review: Repurposing Metformin as a Potential Therapeutic Agent for Oral Cancer
肿瘤(癌症)患者之家