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**Abemaciclib + metformin** is a combination of two small-molecule drugs: abemaciclib, a selective cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, and metformin, a biguanide class oral antidiabetic. Abemaciclib inhibits CDK4 and CDK6, halting cell cycle progression from G1 to S phase, thus blocking cellular proliferation in cancer cells. Metformin activates AMP-activated protein kinase (AMPK), suppresses hepatic gluconeogenesis, and inhibits mitochondrial respiratory-chain complex I, resulting in lowered blood glucose and potential anti-cancer effects via metabolic pathway modulation. The combination has demonstrated synergistic anti-tumor effects in various preclinical cancer models, including reversible cell cycle arrest, suppression of cellular proliferation, and inhibition of the PI3K/mTOR pathway. This combination has been evaluated in clinical research for its enhanced anti-cancer activity, particularly in estrogen receptor-positive cancers, such as recurrent endometrial cancer[1][3][6][7].
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