title: Benefits of Metformin Use for Cholangiocarcinoma.
abstract: Metformin is an oral anti-hyperglycemic agent, which is the most commonly prescribed medication in the treatment of type-2 diabetes mellitus. It is purportedly associated with a reduced risk for various cancers, mainly exerting anti-proliferation effects on various human cancer cell types, such as pancreas, prostate, breast, stomach and liver. This mini-review highlights the risk and benefit of metformin used for cholangiocarcinoma (CCA) prevention and therapy. The results indicated metformin might be a quite promising strategy CCA prevention and treatment, one mechanism being inhibition of CCA tumor growth by cell cycle arrest in both in vitro and in vivo. The AMPK/mTORC1 pathway in intrahepatic CCA cells is targeted by metformin. Furthermore, metformin inhibited CCA tumor growth via the regulation of Drosha-mediated expression of multiple carcinogenic miRNAs. The use of metformin seems to be safe in patients with cirrhosis, and provides a survival benefit. Once hepatic malignancies are already established, metformin does not offer any therapeutic potential. Clinical trials and epidemiological studies of the benefit of metformin use for CCA should be conducted. To date, whether metformin as a prospective chemotherapeutic for CCA is still questionable and waits further atttention.
authors.affiliation: School of Family Medicine and Community Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand E-mail : soraya.k@sut.ac.th.
authors.forename: Soraya J
authors.initials: SJ
authors.lastname: Kaewpitoon
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Loyd
authors.forename: Ratana
authors.initials: R
authors.lastname: Rujirakul
authors.forename: Sukij
authors.initials: S
authors.lastname: Panpimanmas
authors.forename: Likit
authors.initials: L
authors.lastname: Matrakool
authors.forename: Taweesak
authors.initials: T
authors.lastname: Tongtawee
authors.forename: Nusorn
authors.initials: N
authors.lastname: Kootanavanichpong
authors.forename: Ponthip
authors.initials: P
authors.lastname: Kompor
authors.forename: Wasugree
authors.initials: W
authors.lastname: Chavengkun
authors.forename: Jirawoot
authors.initials: J
authors.lastname: Kujapun
authors.forename: Jun
authors.initials: J
authors.lastname: Norkaew
authors.forename: Sukanya
authors.initials: S
authors.lastname: Ponphimai
authors.forename: Natnapa
authors.initials: N
authors.lastname: Padchasuwan
authors.forename: Poowadol
authors.initials: P
authors.lastname: Pholsripradit
authors.forename: Thawatchai
authors.initials: T
authors.lastname: Eksanti
authors.forename: Tanida
authors.initials: T
authors.lastname: Phatisena
authors.forename: Natthawut
authors.initials: N
authors.lastname: Kaewpitoon
mesh_terms: D000818:Animals; D001650:Bile Duct Neoplasms / Q000188:drug therapy*; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects*; D018281:Cholangiocarcinoma / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin