Drug-drug interaction between metformin and sorafenib alters antitumor effect in hepatocellular carcinoma cells

ABSTRACT: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is one of the leading causes of cancer-related deaths worldwide. The multi‐target inhibitor sorafenib is a first-line treatment for patients with advanced unresectable HCC. Recent clinical studies have evidenced that patients treated with sorafenib together with the anti-diabetic drug metformin have a survival disadvantage compared to patients receiving sorafenib only. Here, we examined whether a clinically relevant dose of metformin (50 mg/kg/d) could influence the antitumoral effects of sorafenib (15 mg/kg/d) in a subcutaneous xenograft model of human HCC growth using two different sequences of administration, i.e concomitant versus sequential dosing regimens. We observed that the administration of metformin six hours prior to sorafenib was significantly less effective in inhibiting tumor growth than concomitant administration of the two drugs. In vitro experiments confirmed that pretreatment of different human HCC cell lines with metformin reduced the effects of sorafenib on cell viability, proliferation and signaling. Transcriptomic analysis confirmed significant differences between xenografted tumors obtained under the concomitant and the sequential dosing regimens. Taken together, these observations call into question the benefit of parallel use of metformin and sorafenib in patients with advanced HCC and diabetes, as the interaction between the two drugs could ultimately compromise patient survival. To better characterize the molecular signatures driving the differential responses to concomitant and sequential biotherapies, we conducted a transcriptomic analysis on RNA extracted from tumor xenografts mice xenografed and treated with vehicle (control, n=3), metformin (50 mg/kg/day) combined to sorafenib (15 mg/kg/day) (concomitant schedule, n=3) or metformin (50 mg/kg/day) followed 6 hours later by sorafenib (15 mg/kg/day) (sequential schedule, n=3).

ORGANISM(S): Homo sapiens

PROVIDER: GSE162557 | GEO | 2020/12/03

REPOSITORIES: GEO