Metformin therapy associated with survival benefit in lung cancer patients with diabetes.
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.
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Guoxing
G
Wan
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Xiongjie
X
Yu
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Ping
P
Chen
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Xianhe
X
Wang
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Dongfeng
D
Pan
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Xuanbin
X
Wang
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Linjun
L
Li
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Xiaojun
X
Cai
Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Fengjun
F
Cao
D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality; D008687:Metformin / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D008687:Metformin
diabetes; lung cancer; meta-analysis; metformin; survival