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In conclusion, biguanide inhibitors and other mitochondrial complex I inhibitors have shown considerable promise in overcoming tumor resistance to chemotherapy and targeted drugs, and the application of OXPHOS-related inhibitors and metformin analogues for cancer therapy needs to be examined in future clinical trials

For patients with type 2 diabetes and biopsy-proven NASH with fibrosis, pioglitazone may be considered under specialist supervision, as its use for liver disease is outside its licensed indication (type 2 diabetes) and requires careful assessment of potential risks and contraindications