Exemestane and Metformin Combination

The combination of exemestane and metformin has been investigated in several clinical trials, particularly for postmenopausal women with hormone receptor-positive breast cancer who are overweight or obese. This combination approach is based on the understanding that obesity can lead to worse outcomes in breast cancer patients through mechanisms including insulin resistance and activation of certain cellular pathways. Exemestane is an aromatase inhibitor that reduces estrogen production. Metformin may help overcome endocrine therapy resistance related to insulin resistance in obese women with breast cancer and has been shown to inhibit the mTOR pathway, which is involved in cancer cell growth and proliferation.