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Metformin + sorafenib is an investigational combination therapy being evaluated for the treatment of advanced hepatocellular carcinoma (HCC), specifically for patients at the BCLC-C stage. This combination pairs metformin, a biguanide and AMPK (AMP-activated protein kinase) activator traditionally used for type 2 diabetes, with sorafenib, an oral multi-kinase inhibitor. Metformin is hypothesized to enhance the efficacy of sorafenib by upregulating TIP30 expression and inhibiting metabolic pathways that support tumor growth and metastasis. Sorafenib acts by inhibiting Raf kinases and receptor tyrosine kinases, including VEGFR and PDGFR, thereby suppressing tumor cell proliferation and angiogenesis. This therapeutic approach is currently being investigated in a Phase 2 randomized clinical trial sponsored by Tianjin Medical University Cancer Institute and Hospital.
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