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This therapeutic regimen, currently under investigation by Fudan University, combines the standard-of-care chemotherapy doublet of nab-paclitaxel and gemcitabine with active anti-diabetic management (including metformin, insulin, or other glucose-lowering agents) for patients with metastatic pancreatic cancer and concurrent type 3c diabetes mellitus. The approach aims to evaluate whether optimized glycemic control and the potential synergistic anti-tumor properties of certain anti-diabetic medications can improve clinical outcomes, specifically overall survival, in this patient subset. Nab-paclitaxel acts as a microtubule stabilizer, gemcitabine functions as a nucleoside analog that inhibits DNA synthesis, and the anti-diabetic components target metabolic pathways to manage secondary diabetes and potentially inhibit cancer cell metabolism through mechanisms such as AMPK activation.
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