Tumor microenvironment

Diabetes mellitus

Biology

Cancer

Endocrinology

Oncology

Immunology

Tumor progression

Immunosuppression

Metformin

Angiogenesis

Tumor cells

Cancer research

Genetics

Medicine

Cancer cell

Seminars in Cell and Developmental Biology

The efficacy of metformin in treating cancer has been extensively investigated since epidemiologic studies associated this anti-diabetic drug with a lower risk of cancer incidence. Since tumors are complex systems, in which cancer cells coexist and interact with several different types of non-malignant cells, it is not surprising that anti-cancer drugs affect not only cancer cells, but also the abundance and functions of cells of the tumor microenvironment. Recent years have seen a wide collection of reports showing how metformin, as well as other complex I inhibitors, may influence cancer progression by modulating the phenotype of non-transformed cells in a tumor. In this review, we particularly focus on the effect of metformin on angiogenesis, cancer-associated fibroblasts, tumor-associated macrophages and cancer immunosuppression.

The multifaceted effects of metformin on tumor microenvironment