Metformin therapy associated with survival benefit in lung cancer patients with diabetes

Abstract

The purpose of this study is to summarize the currently available evidence regarding the concerned issue by performing a comprehensive meta-analysis. Relevant publications reporting the association of metformin use with survival of lung cancer patients with diabetes were electronically searched to identify eligible studies. The meta-analysis was performed with hazard ratios (HRs) and 95% confidence intervals (95% CIs) as effect measures for disease-free survival(DFS) and overall survival(OS) estimates. A total of 17 individual studies from 10 publications were included in the meta-analysis. Overall, the results revealed a significant association of metformin use with a better survival of lung cancer patients with diabetes(for DFS: HR = 0.65, 95%CI = 0.52-0.83; for OS: HR = 0.78, 95%CI = 0.64-0.93). The subgroup analyses showed similar association in Asian region(for DFS:HR = 0.69, 95%CI = 0.59-0.80; for OS: HR = 0.55, 95%CI = 0.46-0.67) but not in Western region. Such association was also presented in small cell lung cancer (for DFS: HR = 0.54, 95%CI = 0.38-0.77; for OS: HR = 0.52, 95%CI = 0.39-0.69) and in non-small cell lung cancer(for DFS: HR = 0.70, 95%CI = 0.51-0.96; for OS: HR = 0.75, 95%CI = 0.58-0.97). Analyses stratified by treatment strategy showed a reduction in the risk of cancer-related mortality in patients receiving chemotherapy(for DFS: HR = 0.71, 95%CI = 0.64-0.83; for OS: HR = 0.58, 95%CI = 0.47-0.71) but not in patients receiving chemoradiotherapy. The meta-analysis demonstrated that metformin use was significantly associated with a favorable survival outcome of lung cancer patients with diabetes.

Metformin Inhibited Growth, Invasion and Metastasis of Esophageal Squamous Cell Carcinoma in Vitro and in Vivo

“…Most patients of esophageal cancer are diagnosed at advanced stages of the disease due to lack of alarming symptoms at an early stage and are thus no longer suitable for curative surgery [15,16]. Moreover, it was reported that about 20% of patients experience a recurrence after curative esophagectomy [4]. Unlike cancers such as breast cancer and colon cancer whose prognoses have been improved significantly during the last several decades, the outcome of ESCC remains largely unchanged with a 5-year survival rate being 15% to 25% [15].…”

Prognostic factors for resected non‐small cell lung cancer in patients with type 2 diabetes mellitus

“…Studies have demonstrated the survival benefits of metformin for patients with advanced NSCLC . A recent study by Medairos et al reported that metformin exposure was associated with improved progression‐free survival for diabetic patients with early stage NSCLC .…”

Effect of Metformin on Different Non-Diabetes Related Conditions, a Special Focus on Malignant Conditions: Review of Literature

“…However, another meta-analysis including 17 studies showed metformin had no survival benefit when used as an adjuvant with chemo-radiotherapy while it conferred a better survival outcome to lung cancer patients including those on chemotherapy only [62]. These results were replicated in Menamin et al’s study, which assessed lung cancer patient registry between 1998 and 2009, and they found a weak favorable outcome when metformin was on board before or after diagnosis [63].…”