AMPK/mTORC2/AKT-473/RUNX2 signaling axis modulates epithelial-mesenchymal transition and bone tropism in breast cancer

Introduction: Metformin, a widely used biguanide for the treatment of type 2 diabetes, has been extensively studied for its potential anti-cancer properties, primarily attributed to its inhibitory effects on mTORC1 signaling. However, accumulating evidence suggests that its impact on tumor progression is highly context-dependent, varying with cellular and metabolic conditions. In this study, we investigated the mechanistic effects of metformin on RUNX2 and mTORC2 signaling pathways in breast cancer. Methods: The study was conducted using in silico, in vitro, and in vivo analysis. In vitro experiments was carried out using MDA-MB-231 breast cancer cells to evaluate the regulatory effects of metformin on RUNX2 and mTORC2 signaling. Gene knockdown approaches targeting RICTOR were employed to assess pathway interactions, and molecular analyses were performed to examine the involvement of AMPK and GSK3β in regulating RUNX2 stability and downstream signaling events. Tumor samples were analyzed to validate the clinical relevance of the observed molecular alterations. Additionally, in vivo studies were performed to assess the functional impact of the identified signaling axis on tumor progression and metastatic potential. Results: Metformin treatment resulted in enhanced mTORC2 activity in a RUNX2-dependent manner, mediated through AMPK-driven stabilization of RUNX2. Furthermore, silencing of RICTOR, a critical component of mTORC2, induced RUNX2 degradation via a GSK3β-dependent mechanism, indicating a reciprocal regulatory relationship between RUNX2 and mTORC2 pathways. Functional analyses demonstrated that the AMPK-RUNX2-mTORC2 signaling axis promotes epithelial-mesenchymal transition (EMT) and enhances the bone metastatic potential of breast cancer cells. Discussion: These findings reveal a context-dependent role of metformin in modulating metastatic signaling pathways through the AMPK-RUNX2-mTORC2 axis. The study highlights the complexity of metformin's action in biology and underscores its potential to differentially regulate tumor progression and metastasis depending on the molecular context.