Is there any robust evidence showing that SGLT2 inhibitor predisposes to cancer?

© 2023 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd..

BACKGROUND: The exact pathophysiological mechanisms of SGLT-2 inhibitors in the development, progression or treatment of malignancies are not fully understood, but multiple hypotheses have been proposed. SGLT-2 inhibitors have potential anti-proliferative roles due to several underlying pathophysiological mechanisms, such as inhibition of ATP production, activation of AMPK signalling, induction of apoptosis and ferroptosis, inhibition of glutamate dehydrogenase activity and inhibition of DNA and RNA synthesis. However, heterogeneity among tumour cells and SGLT-2 inhibitor drugs limit the generalizability of pre-clinical studies.

METHODS: This is a narrative review discussing the potential anti-cancer effects of SGLT-2 inhibitors, an oral glucose-lowering medication used in patients with type II diabetes mellitus. This review discusses underlying mechanisms, pre-clinical and clinical trial data, epidemiological data and future perspectives on the use of SGLT-2 inhibitors in cancer treatment.

RESULTS: Type II diabetes is linked to various comorbidities and malignancies, but some glucose-slowering medications may have a preventive role in cancer. The use of SGLT-2 inhibitors was associated with bladder cancer based on mice studies. However, meta-analyses showed no significant increase in overall malignancy incidence of any specific type, except for empagliflozin and bladder cancer association. SGLT-2 inhibitors can potentially reduce the heart damage caused by doxorubicin and sunitinib, while enhancing the anti-cancer effects of doxorubicin. Combining SGLT-2 inhibitors with doxorubicin may allow higher doses of chemotherapy use. Multiple ongoing clinical trials are investigating the potential therapeutic potential of SGLT-2 inhibitors in various types of cancer.

CONCLUSION: More large-scale pre-clinical and clinical studies are needed to explore their potential preventive and therapeutic roles of SGLT-2 inhibitors in cancer treatment. In this narrative review, our aim is to explore the pre-clinical and clinical data regarding the potential anti-cancer effects of SGLT-2 inhibitors including the hypothetical pathophysiological mechanisms.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:54

Enthalten in:

European journal of clinical investigation - 54(2024), 2 vom: 27. Jan., Seite e14131

Sprache:

Englisch

Beteiligte Personen:

Copur, Sidar [VerfasserIn]
Yildiz, Abdullah B [VerfasserIn]
Covic, Adrian [VerfasserIn]
Kanbay, Mehmet [VerfasserIn]

Links:

Volltext

Themen:

80168379AG
Blood Glucose
Canagliflozin
Cancer
Dapagliflozin
Doxorubicin
Empagliflozin
Hypoglycemic Agents
Journal Article
Review
SGLT2 inhibitors
Sodium-Glucose Transporter 2 Inhibitors
Urinary bladder cancer

Anmerkungen:

Date Completed 24.01.2024

Date Revised 24.01.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/eci.14131

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365012432