Can Metformin Improve Liquid Biopsy Accuracy in Cancer Detection?
In oncology research, the presence of tumor DNA in the blood (ctDNA) is highly regarded as a diagnostic or prognostic biomarker. However, in cancer patients, only a fraction of DNA comes from the tumors, with the rest originating mainly from hematopoietic cells [1], making ctDNA detection analogous to finding a needle in a haystack.
Studies on rats indicate that metformin, a medication frequently prescribed for diabetes, combined with X-ray can elevate cell-free DNA (cfDNA) levels in urine by 200–250%. This surge is assumed to result from the cytotoxic effects triggered by metformin.[2]
Building on this, utilizing metformin as a “challenge” to normal and especially tumor cells [3] theoretically might provoke cells to shed additional DNA into circulation, thereby increasing the amount of tumor-derived DNA in the blood and other bodily fluids. As a result, it could increase the sensitivity and specificity of liquid biopsy tests, ultimately improving patient outcomes and survival rates.
- Mattox et al., “The Origin of Highly Elevated Cell-Free DNA in Healthy Individuals and Patients with Pancreatic, Colorectal, Lung, or Ovarian Cancer”, 2023.
- Gaziev et al., “X-rays and metformin cause increased urinary excretion of cell-free nuclear and mitochondrial DNA in aged rats”, 2016.
- Wu et al., “Mechanisms of Cancer Cell Killing by Metformin”, 2023.
