everolimus + octreotide LAR + metformin

This is a combination therapy consisting of three agents: - **Everolimus** is an oral small molecule inhibitor of the mammalian target of rapamycin (mTOR), which plays a key role in cell proliferation, growth, and angiogenesis. It is used primarily as an antineoplastic agent in various cancers, including neuroendocrine tumors. - **Octreotide LAR** (long-acting release) is a synthetic somatostatin analog that inhibits the secretion of several hormones and growth factors involved in tumor progression. It is commonly used to control symptoms and tumor growth in neuroendocrine tumors. - **Metformin** is an oral biguanide antihyperglycemic agent widely used for type 2 diabetes mellitus. In oncology, it has demonstrated potential anticancer effects by activating AMP-activated protein kinase (AMPK), reducing insulin/IGF-1 signaling, and indirectly inhibiting mTOR activity. The rationale for combining these drugs arises from their complementary mechanisms targeting the PI3K-AKT-mTOR pathway—a critical driver in pancreatic neuroendocrine tumor (pNET) cell proliferation. Everolimus directly inhibits mTOR; octreotide LAR suppresses hormone-driven autocrine activation; metformin reduces insulin/IGF-1 levels and activates AMPK to further inhibit mTOR signaling[1][2][5]. This combination has been investigated for its antiproliferative effects in well-differentiated pancreatic neuroendocrine tumors.

Other names

metformin + everolimus + octreotide LAR