metformin + nilotinib

Metformin + nilotinib is an investigational combination therapy consisting of metformin, a first-line oral antihyperglycemic agent for type 2 diabetes, and nilotinib, a small molecule BCR-ABL tyrosine kinase inhibitor approved for the treatment of chronic myeloid leukemia (CML). Preclinical studies suggest that this combination may enhance antileukemia efficacy and help overcome resistance to nilotinib in CML cells. Metformin appears to potentiate the cytotoxic effect of nilotinib by reducing Bcl-xL expression and decreasing phosphorylated JNK levels, thereby restoring sensitivity in resistant CML cell lines. This combination is being explored primarily for its potential benefits in patients with CML who develop resistance to standard TKI therapy or have comorbid diabetes[1][3][4].