metformin + nivolumab (Bristol Myers Squibb)

This combination therapy involves the use of metformin, a biguanide traditionally used for type 2 diabetes, alongside anti-PD-1 monoclonal antibodies such as nivolumab or pembrolizumab. The rationale, investigated in a Phase II trial led by Dan Zandberg (NCT04114136), is that metformin can modulate the tumor microenvironment by activating the AMPK pathway and reducing tumor hypoxia. Preclinical studies suggest that by alleviating hypoxia, metformin enhances the efficacy of PD-1 blockade, leading to improved metabolic fitness and function of CD8+ cytotoxic T cells. The regimen is being evaluated across a broad range of advanced solid tumors to determine if metabolic modulation can reverse immune dysfunction and improve clinical response rates compared to anti-PD-1 monotherapy.

Brand names

GlucophageOpdivoKeytruda

Other names

metformin + pembrolizumabmetformin + anti-PD-1 therapymetformin hydrochloride + nivolumabmetformin hydrochloride + pembrolizumab