The figures have been formulated
using information gained from many different studies, the references
for which are listed at the end of the figures and in the text.
Activating oncogenic (cancer causing) gene mutations are shown in
red and inactivating tumour suppressor gene mutations are shown in
yellow. The effects of metformin on the different stages of the pathways
are shown by arrows. The "up" arrows indicate activation,
the"down" arrows indicate inhibition.
mTOR (mammalian target
of Rapamycin) activation leads to cellular proliferation thus cancer.
There are two complexes making up mTOR - mTORC1 and mTORC2.
Fig
1 shows the complex pathways involved in mTOR inhibition from
the inhibitory effects of metformin on oxidative phosphorylation (respiration)
through AMPK dependent pathways and AMPK independent pathways. Fig
1 also connects to other pathways involved in cancer.
AMPK activation
can also be achieved through calorific restriction and exercise which
are both important in cancer prevention and shown in Fig
1.