二甲双胍（metformin）已在临床上使用了六十年以上。久而久之，人们发现并讨论了许多关于二甲双胍在临床之外的显著效应。除了其在临床上被承认的降血糖作用外，二甲双胍在肿瘤治疗方面也表现出积极影响。然而，目前尚未清楚地证明二甲双胍在人类中的抗肿瘤功效。因此，对现有临床试验进行系统分析是必要的。在这里，我们从“临床试验.gov”数据库中检索了临床试验，以概述二甲双胍在癌症治疗中的临床开发情况，分析现有临床结果，并总结一些有前景的应用于特定癌症治疗的方法。二甲双胍的潜在应用包括三个方向：首先，改善与治疗效果相关的代谢因素，如胰岛素抵抗和周围神经病变；其次，与免疫抗癌治疗（immune checkpoint blockade）相结合；最后，用于激素依赖性癌症的内分泌治疗。尽管一些试验中二甲双胍作为一种再利用药物的结果并不尽如人意，但它仍然有潜力在特定的癌症治疗环境中使用。 © 2023. 本文作者及作者授权独家授予施普林格-费尔拉格德贸易合伙公司德国部分施普林格自然出版集团版权所有。

Metformin has been used clinically for more than six decades. Over time, numerous remarkable effects of metformin beyond the clinic have been discovered and discussed. Metformin has been shown to have a favorable impact on cancer therapy in addition to its clinically recognized hypoglycemic effect. However, the antitumor efficacy of metformin in humans has not been clearly demonstrated yet. Hence, a systematic analysis of the existing trials is necessary.Here, we retrieved clinical trials from the Clinical Trials.gov database to overview the clinical development of metformin for the treatment of cancer, analyze existing clinical results, and summarize some promising applications for specific cancer therapies.The potential application of metformin contains three directions: Firstly, improvement of metabolic factors associated with treatment effects, such as insulin resistance and peripheral neuropathy. Secondly, in combination with immune checkpoint blockade effects. Finally, use it for the endocrine treatment of hormone-dependent cancers.Although the outcomes of metformin as a repurposed agent in some trials have been unsatisfactory, it still has the potential to be used in select cancer therapy settings.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.