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The overall process of the mechanism of metformin on cell cycle arrest and apoptosis. Metformin may regulate apoptosis via two different pathways. Firstly, metformin may decrease AMPK-alpha expression which then indirectly stimulates the cell cycle arrest (AMPK-dependent way). Secondly, metformin may trigger cell cycle arrest in primary breast cancer cells by upregulation of P53 and downregulation of cyclin D1 and which eventually results in cell cycle arrest (AMPK-independent way).
