Pretreatment Insulin Levels as a Prognostic Factor for Breast Cancer Progression

Ferroni, Patrizia; Riondino, Silvia; Laudisi, Anastasia; Portarena, Ilaria; Formica, Vincenzo; Alessandroni, Jhessica; D’Alessandro, Roberta; Orlandi, Augusto; Costarelli, Leopoldo; Cavaliere, F.

doi:10.1634/theoncologist.2015-0462

Cited by 52 publications

(44 citation statements)

References 57 publications

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“…Contrary to what reported for other tumors[39,40], however, neither hyperglycemia nor hyperinsulinemia - and thus HOMA-IR - were associated to CRC clinical-pathological features, whereas pre-treatment HbA 1c levels were associated with advanced disease stage, especially of the mucinous histotype, in non-diabetic CRC patients. Most importantly, elevated pre-treatment HbA 1c levels acted as a negative prognostic factors for OS (HR = 1.43), independently of other well established prognostic factors ( e.g ., stage or ECOG-PS).…”

Section: Discussioncontrasting

confidence: 99%

Prognostic value of glycated hemoglobin in colorectal cancer

Ferroni¹,

Formica²,

Della-Morte³

et al. 2016

WJG

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AIMTo investigate the clinical significance of routinely used glycemic parameters in a cohort of colorectal cancer (CRC) patients.METHODSPre-treatment fasting blood glucose, insulin, HbA1c and homeostasis model of risk assessment (HOMA-IR) were retrospectively evaluated in a case-control study of 224 CRC and 112 control subjects matched for sex, obesity and diabetes frequency and blood lipid profile. Furthermore, the prognostic value of routinely used glycemic parameters towards progression-free (PFS) and overall survival (OS) was prospectively evaluated.RESULTSFasting blood glucose, insulin, HOMA-IR and HbA1c (all P < 0.0001) levels were higher in non-diabetic CRC patients compared with obesity-matched controls. All parameters were associated with increased CRC risk at ROC analysis, but no relationship with clinical-pathological variables or survival outcomes was observed for glycemia, insulinemia or HOMA-IR. Conversely, advanced CRC stage (P = 0.018) was an independent predictor of increased HbA1c levels, which were also higher in patients who had disease progression compared with those who did not (P = 0.05). Elevated HbA1c levels showed a negative prognostic value both in terms of PFS (HR = 1.24) and OS (HR = 1.36) after adjustment for major confounders, which was further confirmed in a subgroup analysis performed after exclusion of diabetic patients.CONCLUSIONHbA1c might have a negative prognostic value in CRC, thus suggesting that glycemic metabolic markers should be carefully monitored in these patients, independently of overt diabetes.

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Section: Discussioncontrasting

confidence: 99%

Prognostic value of glycated hemoglobin in colorectal cancer

Ferroni¹,

Formica²,

Della-Morte³

et al. 2016

WJG

Self Cite

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“…

Ferroni et al described pretreatment insulin levels as a prognostic factor for breast cancer and suggested interventions targeting glucose metabolism with metformin to improve survival of these patients [1]. We recently reviewed this topic [2] and agree with this approach, but we believe that diazoxide should also be mentioned in this context.Diazoxide is a nondiuretic benzothiadiazine that produces hyperglycemia by lowering insulin levels through activation of ATP-sensitive K1-channels and stimulating insulin degradation in the lysosomal system.

…”

mentioning

confidence: 84%

“…Ferroni et al described pretreatment insulin levels as a prognostic factor for breast cancer and suggested interventions targeting glucose metabolism with metformin to improve survival of these patients [1]. We recently reviewed this topic [2] and agree with this approach, but we believe that diazoxide should also be mentioned in this context.…”

mentioning

confidence: 85%

Diazoxide for Lowering Insulin Levels in Breast Cancer Patients

Fink

Klement

2017

The Oncologist

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“…Early changes in diet and modifications of metabolic parameters (blood glucose or lipids levels) may indeed indicate that the tumor is hijacking the host's metabolism for its own energy demand. For instance, experimental models show that modification of insulin levels associated with glycemic dysregulation appears early during cancer development: Pancreatic carcinogenesis (Li, ) and breast cancer are preceded by modifications of blood insulin levels (Ferroni et al., ). Insulin increases glucose use and may also promote cell proliferation, both of which are important for tumor development and progression.…”

Section: Implications For Preventive and Therapeutic Strategiesmentioning

confidence: 99%

Changes in diet associated with cancer: An evolutionary perspective

Thomas

Rome

Mery

et al. 2017

Evolutionary Applications

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Changes in diet are frequently correlated with the occurrence and progression of malignant tumors (i.e., cancer) in both humans and other animals, but an integrated conceptual framework to interpret these changes still needs to be developed. Our aim is to provide a new perspective on dietary changes in tumor‐bearing individuals by adapting concepts from parasitology. Dietary changes may occur alongside tumor progression for several reasons: (i) as a pathological side effect with no adaptive value, (ii) as the result of self‐medication by the host to eradicate the tumor and/or to slow down its progression, (iii) as a result of host manipulation by the tumor that benefits its progression, and finally (iv) as a host tolerance strategy, to alleviate and repair damages caused by tumor progression. Surprisingly, this tolerance strategy can be beneficial for the host even if diet changes are beneficial to tumor progression, provided that cancer‐induced death occurs sufficiently late (i.e., when natural selection is weak). We argue that more data and a unifying evolutionary framework, especially during the early stages of tumorigenesis, are needed to understand the links between changes in diet and tumor progression. We argue that a focus on dietary changes accompanying tumor progression can offer novel preventive and therapeutic strategies against cancer.

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Pretreatment Insulin Levels as a Prognostic Factor for Breast Cancer Progression

Cited by 52 publications

References 57 publications

Prognostic value of glycated hemoglobin in colorectal cancer

Prognostic value of glycated hemoglobin in colorectal cancer

Diazoxide for Lowering Insulin Levels in Breast Cancer Patients

Changes in diet associated with cancer: An evolutionary perspective

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