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however, owing to dynamic changes in disease energy metabolism, where early-stage tumors rely on glycolysis and advanced stages on fatty acid oxidation (FAO), treatment efficacy is often sub-optimal

This results in an overproduction of pro-inflammatory cytokines such as interleukin 6 (IL-6), tumour necrosis factor , adhesion molecules, prostaglandins, and mitogen-activated protein kinase signalling cascades

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This effect may be attributed to the blood glucose-lowering effect of metformin, which maintains a glucose-deprived environment unfavorable for cancer cell growth, thus increasing the efficacy of chemotherapy

The plaintiffs also threw in a reference to the June U.S