Immune-mediated antitumor effect by type 2 diabetes drug, metformin

S Eikawa, M Nishida, S Mizukami… - Proceedings of the …, 2015 - National Acad Sciences
S Eikawa, M Nishida, S Mizukami, C Yamazaki, E Nakayama, H Udono
Proceedings of the National Academy of Sciences, 2015National Acad Sciences
Metformin, a prescribed drug for type 2 diabetes, has been reported to have anti-cancer
effects; however, the underlying mechanism is poorly understood. Here we show that this
mechanism may be immune-mediated. Metformin enabled normal but not T-cell–deficient
SCID mice to reject solid tumors. In addition, it increased the number of CD8+ tumor-
infiltrating lymphocytes (TILs) and protected them from apoptosis and exhaustion
characterized by decreased production of IL-2, TNFα, and IFNγ. CD8+ TILs capable of …
Metformin, a prescribed drug for type 2 diabetes, has been reported to have anti-cancer effects; however, the underlying mechanism is poorly understood. Here we show that this mechanism may be immune-mediated. Metformin enabled normal but not T-cell–deficient SCID mice to reject solid tumors. In addition, it increased the number of CD8+ tumor-infiltrating lymphocytes (TILs) and protected them from apoptosis and exhaustion characterized by decreased production of IL-2, TNFα, and IFNγ. CD8+ TILs capable of producing multiple cytokines were mainly PD-1Tim-3+, an effector memory subset responsible for tumor rejection. Combined use of metformin and cancer vaccine improved CD8+ TIL multifunctionality. The adoptive transfer of antigen-specific CD8+ T cells treated with metformin concentrations as low as 10 μM showed efficient migration into tumors while maintaining multifunctionality in a manner sensitive to the AMP-activated protein kinase (AMPK) inhibitor compound C. Therefore, a direct effect of metformin on CD8+ T cells is critical for protection against the inevitable functional exhaustion in the tumor microenvironment.
National Acad Sciences