Impact of metformin use on survival outcomes in non-small cell lung cancer treated with platinum

Abstract

Preclinical evidence suggests that metformin, a widely used antidiabetic drug, may have a sensitizing effect on platinum. The purpose of this study was to evaluate the survival outcomes for non-small cell lung cancer (NSCLC) patients with type 2 diabetes mellitus (T2DM) using metformin during platinum-based chemotherapy.The clinicopathological parameters and survival data of 75 NSCLC patients with T2DM from January 2008 to December 2011 were collected and analyzed retrospectively. Patients were divided into 2 groups: metformin exposure group (n = 27) and non-metformin group (patients using other hypoglycemic agents or no drug for controlling n = 48). Univariate and multivariate analyses were performed to assess the association of metformin usage with overall survival (OS).Mean follow-up time was 58.7 months. The mean survival time was 36.74 months in the metformin group and 40.21 months in the non-metformin group. There was no significant difference in survival time between the 2 groups (P = .661). After adjusting gender, age, smoking status, tumor stage, tumor histology, and differentiation, multivariate analysis showed that metformin was not associated with the OS in NSCLC patients treated with concurrent platinum-based chemotherapy (hazard ratio: 1.071, 95% confidence interval: 0.577–1.986, P = .828).Our results indicated that metformin exposure had no significant effect on OS in NSCLC patients treated with platinum-based chemotherapy. Further studies are warranted to evaluate whether metformin could affect the survival of NSCLC patients treated with platinum-based chemotherapy.

Metformin Adjunct With Antineoplastic Agents for the Treatment of Lung Cancer: A Meta-Analysis of Randomized Controlled Trials and Observational Cohort Studies

“…The results of some studies showed that metformin, when used in combination with antineoplastic agents, appears to improve the antitumor effect of anticancer agents ( Tan et al, 2011 ; Chen et al, 2015 ; Kong et al, 2015 ; Lin et al, 2015 ; Xu et al, 2015 ; Afzal et al, 2019 ; Arrieta et al, 2019 ; Hung et al, 2019 ). However, several studies have reported no effect of adjuvant metformin therapy on survival outcomes ( Ahmed et al, 2015 ; Sayed et al, 2015 ; Wink et al, 2016 ; Lu et al, 2018 ; Wen-Xiu et al, 2018 ; Li et al, 2019 ). Moreover, no systematic review of previous studies has evaluated the efficacy of metformin in combination with anticancer drugs for the treatment of lung cancer.…”

Metformin-induced chemosensitization to cisplatin depends on P53 status and is inhibited by Jarid1b overexpression in non-small cell lung cancer cells

“…Non-small cell lung cancer is among the most lethal tumors and treatment frequently has a poor prognosis. A recent publication shows that metformin has no impact in platinum-based therapy for NSCLC [ 33 ]. Another publication shows that metformin enhances cisplatin-induced sensitivity to radiotherapy in two wild type P53 cell lines [ 34 ].…”

Addition of metformin for non-small cell lung cancer patients receiving antineoplastic agents

“…Eight of the remaining reports were included after review of the full texts, and 11 available studies were included from previous relevant meta-analyses. Thus, a total of 19 studies were included in this meta-analysis (Tan et al, 2011;Ahmed et al, 2015;Chen et al, 2015;Lin et al, 2015;Sayed et al, 2015;Wink et al, 2016;Wen-Xiu et al, 2018;Afzal et al, 2019;Arrieta et al, 2019;Hung et al, 2019;Li et al, 2019;Su et al, 2020;Cortellini et al, 2021;Han et al, 2021;Jacobi et al, 2021;Lee et al, 2021;Skinner et al, 2021;Tsakiridis et al, 2021;Wang Y. et al, 2021). The specific literature retrieval process is presented in Figure 1.…”