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Metformin synergistically enhances antitumor activity of cisplatin in gallbladder cancer via the PI3K/AKT/ERK pathway

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Abstract

Metformin (Met) is a widely used antidiabetic drug and has demonstrated interesting anticancer effects in various cancer models, alone or in combination with chemotherapeutic drugs. The aim of the present study is to investigate the synergistic effect of Met with cisplatin (Cis) on the tumor growth inhibition of gallbladder cancer cells (GBC-SD and SGC-996) and explore the underlying mechanism. Cells were treated with Met and/or Cis and subjected to cell viability, colony formation, apoptosis, cell cycle, western blotting, xenograft tumorigenicity assay and immunohistochemistry. The results demonstrated that Met and Cis inhibited the proliferation of gallbladder cancer cells, and combination treatment with Met and Cis resulted in a combination index < 1, indicating a synergistic effect. Co-treatment with Met and Cis caused G0/G1 phase arrest by upregulating P21, P27 and downregulating CyclinD1, and induced apoptosis through decreasing the expression of p-PI3K, p-AKT, and p-ERK. In addition, pretreatment with a specific AKT activator (IGF-1) significantly neutralized the pro-apoptotic activity of Met + Cis, suggesting the key role of AKT in this process. More importantly, in nude mice model, Met and Cis in combination displayed more efficient inhibition of tumor weight and volume in the SGC-996 xenograft mouse model than Met or Cis alone. Immunohistochemistry analysis suggests the combinations greatly suppressed tumor proliferation, which is consistent with our in vitro results. In conclusion, our findings indicate that the combination therapy with Met and Cis exerted synergistic antitumor effects in gallbladder cancer cells through PI3K/AKT/ERK pathway, and combination treatment with Met and Cis would be a promising therapeutic strategy for gallbladder cancer patients.

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Acknowledgements

This study was supported by the Program for Young Scientist in Science and Education of Suzhou City (No. KJXW2014053), the Program for Young Scientist in Science and Education of Wujiang No. 1 People’s Hospital (No. 201724).

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  1. Tingting Bi and Ao Zhu have contributed equally to this work.

Authors and Affiliations

  1. Department of Geriatric Ward, Wujiang No. 1 People’s Hospital, Suzhou, 215200, China

    Tingting Bi, Ao Zhu, Xufeng Yang, Huiying Qiao, Jinmei Tang & Rong Lv

  2. Department of General Surgery, Wujiang No. 1 People’s Hospital, Suzhou, 215200, China

    Yan Liu

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  1. Tingting Bi
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  2. Ao Zhu
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  3. Xufeng Yang
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  6. Yan Liu
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Correspondence to Rong Lv.

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Bi, T., Zhu, A., Yang, X. et al. Metformin synergistically enhances antitumor activity of cisplatin in gallbladder cancer via the PI3K/AKT/ERK pathway. Cytotechnology 70, 439–448 (2018). https://doi.org/10.1007/s10616-017-0160-x

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  • DOI: https://doi.org/10.1007/s10616-017-0160-x

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