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This combination therapy regimen consists of the BRAF inhibitor dabrafenib, the MEK inhibitor trametinib, and the biguanide metformin. It is being investigated by the University of Louisville for the treatment of unresectable stage IIIC and stage IV BRAF V600E-mutant melanoma. The rationale for adding metformin to the standard-of-care dabrafenib/trametinib doublet is to overcome or delay resistance by targeting metabolic pathways and activating AMPK, which may inhibit the MAPK pathway and reduce cell proliferation. Metformin is hypothesized to enhance the efficacy of MAPK inhibitors by disrupting the metabolic adaptations that cancer cells use to survive and develop resistance to targeted therapies.
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