Sorafenib and metformin: to be, or not to be, that is the question

Giulia Orsi, Andrea Casadei-Gardini


Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and ranks second among global causes of cancer-related death (1). The epidemiological and etiological landscape of the disease is facing remarkable changes, due to an increasing incidence of non-alcoholic fatty liver disease (NAFLD)-associated HCC and a concomitant decrease of virus-related cases over the last two decades in Western countries (1). High prevalence of metabolic syndrome in particular in Caucasian patients is contributing to this trend. Moreover, the growing spread of these metabolic conditions in Asian countries is likely to translate into a significant increase in NAFLD-related HCC in the future even in this geographic area (1). In this scenario, exploring the impact of diabetes and anti-diabetic medications on HCC tumorigenesis and prognosis has become of paramount importance.