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ACTOplus Met XR is a fixed-dose combination pharmaceutical containing the thiazolidinedione pioglitazone hydrochloride and the biguanide metformin hydrochloride in an extended-release formulation. Pioglitazone is a potent and selective agonist for the peroxisome proliferator-activated receptor-gamma (PPAR-gamma), which regulates the transcription of insulin-responsive genes involved in glucose control and lipid metabolism. Metformin works primarily by decreasing hepatic glucose production and improving insulin sensitivity. While originally approved for the treatment of type 2 diabetes mellitus, this combination is being investigated by the National Cancer Institute (NCI) for its potential chemopreventive and anti-tumor effects in patients with squamous cell carcinoma of the oral cavity or oropharynx, potentially by slowing disease progression through metabolic and anti-proliferative pathways.
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