title: The biguanides metformin and phenformin inhibit angiogenesis, local and metastatic growth of breast cancer by targeting both neoplastic and microenvironment cells.
abstract: The human white adipose tissue (WAT) contains progenitors with cooperative roles in breast cancer (BC) angiogenesis, local and metastatic progression. The biguanide Metformin (Met), commonly used for Type 2 diabetes, might have activity against BC and was found to inhibit angiogenesis in vivo. We studied Met and another biguanide, phenformin (Phe), in vitro and in vivo in BC models. In vitro, biguanides activated AMPK, inhibited Complex 1 of the respiratory chain and induced apoptosis of BC and WAT endothelial cells. In coculture, biguanides inhibited the production of several angiogenic proteins. In vivo, biguanides inhibited local and metastatic growth of triple negative and HER2+ BC in immune-competent and immune-deficient mice orthotopically injected with BC. Biguanides inhibited local and metastatic BC growth in a genetically engineered murine model model of HER2+ BC. In vivo, biguanides increased pimonidazole binding (but not HIF-1 expression) of WAT progenitors, reduced tumor microvessel density and altered the vascular pericyte/endothelial cell ratio, so that cancer vessels displayed a dysplastic phenotype. Phe was significantly more active than Met both in vitro and in vivo. Considering their safety profile, biguanides deserve to be further investigated for BC prevention in high-risk subjects, in combination with chemo and/or targeted therapy and/or as post-therapy consolidation or maintenance therapy for the prevention of BC recurrence.
authors.affiliation: Laboratory of Hematology-Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Orecchioni
authors.forename: Francesca
authors.initials: F
authors.lastname: Reggiani
authors.forename: Giovanna
authors.initials: G
authors.lastname: Talarico
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mancuso
authors.forename: Angelica
authors.initials: A
authors.lastname: Calleri
authors.forename: Giuliana
authors.initials: G
authors.lastname: Gregato
authors.forename: Valentina
authors.initials: V
authors.lastname: Labanca
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Noonan
authors.forename: Katiuscia
authors.initials: K
authors.lastname: Dallaglio
authors.forename: Adriana
authors.initials: A
authors.lastname: Albini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bertolini
mesh_terms: D055372:AMP-Activated Protein Kinases / Q000378:metabolism; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001943:Breast Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D045744:Cell Line, Tumor; D042967:Electron Transport Complex I / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D008687:Metformin / Q000494:pharmacology*; D051379:Mice; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic / Q000517:prevention & control*; D010629:Phenformin / Q000494:pharmacology*; D010766:Phosphorylation; D058570:TOR Serine-Threonine Kinases / Q000378:metabolism; D059016:Tumor Microenvironment
chemical_list: D008687:Metformin; D010629:Phenformin; D058570:TOR Serine-Threonine Kinases; D055372:AMP-Activated Protein Kinases; D042967:Electron Transport Complex I
keywords: angiogenesis; breast cancer; metformin; phenformin