Aim:
Background: Saxagliptin (SAXA), a dipeptidyl peptidase-4 (DPP-4) inhibitor, is primarily used in type 2 diabetes treatment. Recent research suggests that DPP-4 inhibitors may have anti-cancer capabilities. This study evaluates the cytotoxic and apoptotic effects of SAXA, alone and in combination with cyclophosphamide (CP), on the A549 lung cancer cell line. Aim: To evaluate the anti-tumor potential of SAXA on A549 cells and assess its combinatory effects with CP on cell viability and apoptosis markers.

Material and methods:
Materials and Methods: Four primary groups were utilized from A549 lung cancer cell lines: unprocessed Cells (control), cells subjected to CP treatment, cells subjected to SAXA treatment, and cells treated with CP plus SAXA, thereby obtained a combination of varying concentrations of CP and SAXA. Five used concentrations (62.5, 125, 250, 500 and 1000) μg/mL for SAXA and 0.9, 1.87, 3.75, 7.5, and 15 μg/mL for CP with four duplicates employed for each treated group. Incubated for 72hr., cells gathered, centrifuged, and supernatants were eliminated, while particles were gathered to determine BCL2 and BAX levels using ELISA test kits

Results:
Results: SAXA dramatically reduced A549 cell viability in a dose-dependent manner. The combination of SAXA and CP also displayed cytotoxicity; however, no synergistic effect was found above CP alone. Notably, the combined treatment dramatically lowered BCL2 levels (p < 0.001), but BAX levels remained stable (p > 0.05).

Conclusions:
Conclusion: SAXA showed promising anti-cancer action against A549 cells. Although the combination with CP did not boost cytotoxicity, the observed pro-apoptotic reduction in BCL2 implies potential therapeutic efficacy.