Effect of metformin on the incidence of head and neck cancer in diabetics

Yen, Yung-Chang; Lin, Charlene; Lin, Shih Wei; Lin, Yi Hui; Weng, Shih‐Feng

doi:10.1002/hed.23743

Cited by 54 publications

(58 citation statements)

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“…The studies were conducted in 2 different countries: the United States of America [9,20] and Taiwan [21]. All 3 studies were published recently (1 article in 2012 and 2 articles in 2014) and were written in English.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…This process led to exclusion of 21 studies (Appendix 2, [56][57][58][59][60][61][62][63][64][65]). In the end, only 3 articles [9,20,21] were selected. A flow chart detailing the process of identification, inclusion, and exclusion of studies is shown in Fig.…”

Section: Study Selectionmentioning

confidence: 99%

“…It is also described that metformin suppresses tumor growth in animal models of ovarian cancer [14], melanoma [15], prostate cancer [16] and breast carcinoma [17]. Furthermore, this drug was also found to be associated with improved overall survival among diabetic patients with breast, prostate, colorectal or head and neck cancer [9,[18][19][20][21]. Although Decensi et al [3] in 2010 performed a systematic review and meta-analysis on metformin and cancer risk in diabetic patients, they did not analyze head and neck cancer patients.…”

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confidence: 96%

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Effects of metformin on head and neck cancer: A systematic review

et al. 2015

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

mentioning

confidence: 96%

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Effects of metformin on head and neck cancer: A systematic review

et al. 2015

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“…In agreement with current study, some previous studies have reported a decreased cancer risk among metformin users. However, the protective effect of metformin use on HNC is not conclusive [21,22]. Sikka et al [28] demonstrated that metformin may inhibit cell growth in squamous cell carcinoma of the head and neck.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on the association between DM and the risk of HNC that take into account metformin use have also reported conflicting results. A Taiwanese study reported a decreased risk of HNC among metformin users (adjusted hazard ratio = 0.66; 95% confidence interval [CI] 0.55-0.79) [21], while another study in the United Kingdom reported no association [22].…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus, metformin and head and neck cancer

et al. 2016

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Phase 1 dose‐finding study of metformin in combination with concurrent cisplatin and radiotherapy in patients with locally advanced head and neck squamous cell cancer

Gulati

Desai

Palackdharry

et al. 2019

Cancer

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BACKGROUND:The 5-year overall survival (OS) rate remains at 50% for patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC), thereby underscoring the need for improved treatments. An antidiabetic agent, metformin, was found in retrospective studies to improve survival in patients with HNSCC. Therefore, the authors conducted a phase 1 dose escalation study combining metformin with chemoradiotherapy in patients with LAHNSCC. METHODS: Nondiabetic patients with LAHNSCC were enrolled in the current study to receive escalating doses of metformin and CRT based on the modified toxicity probability interval design. Metformin cohort doses included 2000 mg, 2550 mg, and 3000 mg daily in divided doses in addition to cisplatin (at a dose of 100 mg/m 2 on days 1, 22, and 43) and standard radiotherapy (70 grays). Adverse events were categorized as per the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03). RESULTS: Twenty patients were enrolled, 2 of whom withdrew consent. The median age of the patients was 56 years and the majority were male (83%), were white (88%), had p16-positive disease (72%), and were tobacco users (61%). The median length of metformin exposure was 28.5 days. The most common grade ≥3 toxicities were nausea (11%), vomiting (11%), mucositis (6%), acute kidney injury (17%), anemia (6%), and leukopenia (11%). Dose-limiting toxicities included diarrhea and acute kidney injury. After a median follow-up of 19 months, the 2-year overall survival and progression-free survival rates were 90% and 84%, respectively. No hypoglycemia events or lactic acidosis were observed. Cisplatin administration did not appear to affect metformin pharmacokinetics. The maximum tolerated dose for metformin could not be determined given the limited number of patients who tolerated metformin during chemoradiotherapy. CONCLUSIONS: To the authors' knowledge, the current study is the first phase 1 trial combining metformin with chemoradiotherapy. Rates of overall survival and progression-free survival were encouraging in this limited patient population, and warrant further investigation in a phase 2 trial. Cancer 2020;126:354-362.

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Effect of metformin on the incidence of head and neck cancer in diabetics

Abstract: Metformin is associated with a lower risk of developing head and neck cancer in patients with diabetes.

Cited by 54 publications

References 30 publications

Effects of metformin on head and neck cancer: A systematic review

Effects of metformin on head and neck cancer: A systematic review

Diabetes mellitus, metformin and head and neck cancer

Phase 1 dose‐finding study of metformin in combination with concurrent cisplatin and radiotherapy in patients with locally advanced head and neck squamous cell cancer

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