Head and neck cancers (HNC) are the sixth most common malignancy worldwide. Over 70% of new HNC are locally advanced diseases requiring multi-modality treatment. Despite improved outcomes with CRT, there is still a high level of disease recurrence, especially in the HPV-negative, smoking population, necessitating improved treatment regimens.

Treatment combinations involving immunotherapy have emerged as promising options to combat advanced stage disease. Additionally, alternative drug development studies have begun to explore repurposing medications originally intend to treat non-cancer diseases. Metformin is FDA approved to treat type II diabetes and has been recently examined in cancer clinical trials and have been shown to have anticancer effects in solid tumors.