Prolonged Survival in Lung Cancer Patients with Diabetes Mellitus

Abstract

We appreciate your interest in our article published in the Journal of Thoracic Oncology 1 and thank you for the opportunity to answer your questions. In our article, we analyzed the influence of diabetes mellitus on the survival of patients with lung cancer. We found that lung cancer patients with diabetes mellitus had a longer survival compared with patients without diabetes mellitus. The mean age at baseline in the Nord-Trøndelag Health Study (HUNT) for patients with lung cancer was 59 years, and 4.5% among these had self-reported diabetes mellitus. Similar prevalence has been reported in other studies for comparable age groups, 2 and these estimates are also in line with the prevalence in the total HUNT study population at this age. 3,4 The mean age at the time of diagnoses of lung cancer was 70 years. In the HUNT study, diabetes mellitus was defined by the answer "yes" to the question "Do you have or have you had diabetes?" independent of whether or not the person used medication for diabetes mellitus. Self-reported diabetes mellitus is a widely accepted and used tool in epidemiological studies. 5 The question on self-reported diagnosis has also been validated in the HUNT study population. 6 We therefore believe that our definition of the variable "diabetes mellitus" can be used in the current setting. Dr. Satoh is of course right regarding change in the treatment of diabetes mellitus in the last decades. We agree that information on whether patients

Role of Comorbidity on Survival after Radiotherapy and Chemotherapy for Nonsurgically Treated Lung Cancer

“…Diabetes may provide the exception as this comorbid condition may actually improve prognosis although data are conflicting. 11,12 It has been suggested that CCI may not be the best measure of comorbidity because it does not necessarily capture the relevant comorbidities. 13 Some comorbidities that may be important for choice of systemic treatment in LC such as polyneuropathy and benign hematologic conditions are not part of the score basis for CCI.…”

Incidental Receipt of Cardiac Medications and Survival Outcomes Among Patients With Stage III Non–Small-Cell Lung Cancer After Definitive Radiotherapy

“…Patients were included in the ACEIs category if they had received the medication throughout the radiotherapy. In addition to receipt of ACEIs as a binary variable, we also tabulated receipt of ARBs, 29 b-blockers, 30 statins, 31,32 aspirin, 33 and the presence of chronic pulmonary disease 32,34 or diabetes mellitus, 35 any of which could affect outcomes in lung cancer treatment and thus confound the analysis of the receipt of ACEIs. The following study outcomes were assessed: locoregional progressionfree survival (LRPFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS).…”

Weekly nab-Paclitaxel in Combination With Carboplatin as First-Line Therapy in Patients With Advanced Non–Small-Cell Lung Cancer: Analysis of Safety and Efficacy in Patients With Diabetes

“…16,17 While some evidence has suggested that diabetes is associated with increased survival in lung cancer, several studies have shown the opposite. [18][19][20][21][22] A retrospective study evaluated the prognostic value of several clinical characteristics of 442 patients with advanced NSCLC receiving first-line, platinum-based doublet chemotherapy and concluded that the presence of diabetes at baseline was a significant negative prognostic factor for both progression-free survival (PFS) and overall survival (OS). 23 On the basis of these and other previously published data, improved treatment options for patients with diabetes and advanced NSCLC may be needed.…”

“…23 On the basis of these and other previously published data, improved treatment options for patients with diabetes and advanced NSCLC may be needed. [18][19][20][21]23 nab-paclitaxel in combination with carboplatin (nab-P/C) is approved for the first-line treatment of locally advanced or metastatic NSCLC in patients who are not candidates for curative surgery or radiation therapy. 9 In a large, multicenter phase 3 trial, firstline nab-P/C significantly improved the primary end point (overall response rate [ORR]) over solvent-based paclitaxel plus carboplatin (sb-P/C; 33% vs. 25%; response rate ratio [RRR], 1.313; 95% confidence interval [CI], 1.082-1.593; P ¼ .005), with a trend toward improved OS and PFS.…”