title: Metformin Prevents the Progression of Dysplastic Mucosa of the Head and Neck to Carcinoma in Nondiabetic Patients.
abstract: OBJECTIVE
  Metformin is an oral anti-hyperglycemic agent used to treat type 2 diabetes mellitus (DM). In vitro and animal models have shown that metformin can prevent the progression of oral lesions to carcinoma; however, there is conflicting data in the clinical literature regarding risk reduction for malignancy in head and neck cancer (HNC).
  
  
  METHODS
  Case series.
  
  
  METHODS
  We present 3 cases in which adjuvant metformin therapy was used to treat recurrent and multifocal dysplastic lesions in previously treated nondiabetic HNC patients.
  
  
  RESULTS
  Patients included 1 with a history of oral cavity squamous cell carcinoma (SCC) and 2 with a history of laryngeal SCC. Follow-up time ranged between 3 and 33 months. All 3 patients showed complete or partial regression of the remaining mucosal lesions and did not require any additional surgeries.
  
  
  CONCLUSIONS
  We present 3 cases of nondiabetic HNC patients with field cancerization who showed a good response to adjuvant therapy with metformin. The nondiabetic population is not affected by confounding factors such as increased risk of malignancy and decreased overall survival that is itself associated with abnormal glucose metabolism and is therefore an excellent cohort in which to study the use of adjuvant metformin therapy in HNC patients.
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Michael Zvi
authors.initials: MZ
authors.lastname: Lerner
authors.affiliation: 2 Maimonides Medical Center, Voice and Swallowing Disorders, Division of Otolaryngology-Head and Neck Surgery, Brooklyn, New York, USA.
authors.forename: Niv
authors.initials: N
authors.lastname: Mor
authors.affiliation: 3 Yale New Haven Health System, New Haven, Connecticut, USA.
authors.forename: Hyung
authors.initials: H
authors.lastname: Paek
authors.affiliation: 4 New York Center for Voice and Swallowing Disorders, New York, New York, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Blitzer
authors.affiliation: 4 New York Center for Voice and Swallowing Disorders, New York, New York, USA.
authors.forename: Marshall
authors.initials: M
authors.lastname: Strome
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D005931:Glottis; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007822:Laryngeal Neoplasms / Q000628:therapy*; D007971:Leukoplakia / Q000188:drug therapy*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D009062:Mouth Neoplasms / Q000628:therapy*; D009092:Mucous Membrane; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000628:therapy*
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin
keywords: dysplasia; head and neck cancer; laryngeal neoplasms; mTORC; mammalian target of rapamycin complex; metformin; oral cavity cancer