Poor glycemic control might compromise the efficacy of chemotherapy in non‐small cell lung cancer patients with diabetes mellitus

Abstract

Background: Previous studies indicated that type 2 diabetes mellitus (T2DM) is related to an increased lung cancer risk, but its role in the prognosis of NSCLC remains conflicting. This study investigated the impact of blood glucose control on the outcomes in NSCLC patients with T2DM treated with platinum-based doublets. Methods: Clinicopathological and survival data from 191 T2DM patients with advanced NSCLC, who received platinum-based chemotherapy, were retrospectively analyzed. Based on the blood glucose conditions during chemotherapy, patients were classified into poor (n = 84) and good control (n = 107) groups. Progression-free survival (PFS) was assessed using the Kaplan-Meier method. Results: The median PFS among patients with good glycemic control [197.0 (95% CI: 136.3-257.7) days] was longer than that among those with poor control [132.0 (95% CI: 112.5-151.5) days] (P = .0003). Further subgroup analysis of lung squamous carcinoma and adenocarcinoma patients showed that the median PFS of the good control group was also significantly longer than that of the poor control group [179.0 (95% CI: 78.4-279.6) days vs 125.0 (95% CI: 110.9-139.1) days, P = .0014;197.0 (95% CI: 124.3-269.7) days vs 154.0 (95% CI: 129.9-178.1) days, P = .0359; respectively]. The incidence rates of side effects were similar among patients with good glycemic control and those with poor glycemic control (all P > .05). Conclusions: Satisfactory glycemic control during platinum-based chemotherapy might provide a survival benefit to T2DM patients with NSCLC. Further studies are warranted to confirm our findings. K E Y W O R D Sglycemic control level, non-small cell lung cancer, platinum-based chemotherapy, progression-free survival, type 2 diabetes mellitus | 903 ZENG Et al.

Metformin and better survival in type 2 diabetes patients with NSCLC during EGFR‐TKI treatment: Implications of miR‐146a?

“…Type 2 diabetes mellitus (T2DM) has been associated with an increased lung cancer risk. 1,2 It has been found that poor glycemic control reduces the efficacy of chemotherapy in non-small cell lung cancer (NSCLC) patients affected by diabetes mellitus. 1 NSCLC accounts for approximately 75%-85% of all cases of lung cancer.…”

“…1,2 It has been found that poor glycemic control reduces the efficacy of chemotherapy in non-small cell lung cancer (NSCLC) patients affected by diabetes mellitus. 1 NSCLC accounts for approximately 75%-85% of all cases of lung cancer. 3 Metformin has become the favorite first-line oral blood glucose-lowering agent for the treatment of T2DM.…”

“…4 It has been demonstrated that metformin exerts anticancer activities in several types of cancer. 1,2 It has been observed that T2DM cancer patients on treatment with metformin show a reduced cancer-related mortality in comparison to those treated with sulfonylurea and insulin therapy. 5 Metformin administration has recently been linked to a significantly lower risk of death, as well as a significantly longer median persistent progression-free survival and median overall survival in T2DM lung cancer patients receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy.…”

Identifying ways to improve diabetes management during cancer treatments (INDICATE): protocol for a qualitative interview study with patients and clinicians

“…Moreover, numerous studies show that, compared with other patients with cancer, those with pre-existing diabetes have higher perioperative and longer term mortality 6 25–27 30–34. Though findings are not uniform, there is accumulating evidence that suboptimal glycaemic control during cancer treatment is a contributory driver of worse cancer-related outcomes in patients with comorbid diabetes 28 35–41. Retrospective studies of patients with cancer with comorbid diabetes have shown, for example, that good perioperative glycaemic control is associated with reduced risk of morbidity and death following colectomy for colon cancer35 and good glycaemic control prior to neoadjuvant chemotherapy for cervical cancer is associated with superior tumour response and survival 37.…”

Identification of LncRNA CARD8-AS1 as a Potential Prognostic Biomarker Associated With Progression of Lung Adenocarcinoma

“…In the past decades, considerable progress has been made in surgical treatment, radiotherapy, chemotherapy, molecular targeted therapy, and immunotherapy for lung cancer [2][3][4]. However, most NSCLC patients are already in the advanced stage during their initial diagnosis, resulting in a poor five-year overall survival rate of these patients [5]. In order to improve survival from lung adenocarcinoma, new biomarkers, therapeutic targets, and drugs for treating patients with lung adenocarcinoma are needed.…”