metformin + dexamethasone

Metformin is a biguanide small molecule drug, originally FDA-approved for the treatment of type 2 diabetes mellitus, that is being repurposed by the University of Campinas, Brazil, for the treatment of relapsed or refractory multiple myeloma. In this clinical context, metformin is administered as an extended-release formulation (Metformin XR) in combination with high-dose dexamethasone. The therapeutic rationale is based on metformin's ability to disrupt cellular energy metabolism by inhibiting mitochondrial complex I, which activates the AMP-activated protein kinase (AMPK) pathway and subsequently inhibits the mammalian target of rapamycin (mTOR) signaling. This metabolic stress, combined with the pro-apoptotic and anti-inflammatory effects of the glucocorticoid dexamethasone, is intended to provide synergistic anti-tumor activity in patients who have failed prior lines of therapy.

Brand names

GlucophageGlucophage XRFortametGlumetza

Other names

metformin hydrochloridemetformin XRHDdexa