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Metformin is a biguanide small molecule traditionally used for type 2 diabetes, currently being repurposed for its potential anti-tumor properties. In a clinical trial sponsored by Peking University (NCT03833466), metformin is being investigated as a neoadjuvant therapy in combination with the standard chemotherapy agents cisplatin and paclitaxel for patients with advanced esophageal squamous cell carcinoma (ESCC). The mechanism of action involves the activation of adenosine monophosphate-activated protein kinase (AMPK), which leads to the inhibition of the mTOR signaling pathway, as well as the modulation of the IL-6/JAK2/STAT3 axis. This combination aims to improve the efficacy of conventional chemotherapy in treating aggressive esophageal malignancies.
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