*Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; †School of Population Health, University of Queensland, Brisbane, Australia; ‡School of Pharmacy, University of Wisconsin-Madison, Madison, WI; §Discipline of Pharmacy, Monash University Sunway Campus, Malaysia; and ∥Faculty of Medicine, Chulalongkorn University, Bangkok; ¶Faculty of Public Health, Naresuan University, Phitsanulok; and #School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.
Int J Gynecol Cancer. 2013 Nov;23(9):1544-51. doi: 10.1097/IGC.0b013e3182a80a21.
The potential therapeutic effects of metformin on several cancers were reported. However, the evidence of the effects of metformin on ovarian cancer is still limited and inconclusive. This systematic review and meta-analysis study aim to summarize the existing evidence of the therapeutic effects of metformin on ovarian cancer.
We performed systematic searches using electronic databases including PubMed and EMBASE until December 2012. Key words included "metformin" AND ("ovarian cancer" OR "ovary tumor"). All human studies assessing the effects of metformin on ovarian cancer were eligible for inclusion. All articles were reviewed independently by 2 authors with a standardized approach for the purpose of study, study design, patient characteristics, exposure, and outcomes. The data were pooled using a random-effects model.
Of 190 studies retrieved, only 3 observational studies and 1 report of 2 randomized controlled trials were included. Among those studies, 2 reported the effects of metformin on survival outcomes of ovarian cancer, whereas the other 2 reported the effects of metformin on ovarian cancer prevention. The findings of studies reporting the effects on survival outcomes indicated that metformin may prolong overall, disease-specific, and progression-free survival in ovarian cancer patients. The results of studies reporting the effects of metformin on ovarian cancer prevention were meta-analyzed. It indicated that metformin tended to decrease occurrence of ovarian cancer among diabetic patients with the pooled odds ratio of 0.57 (95% confidence interval, 0.16-1.99).
Our findings showed the potential therapeutic effects of metformin on survival outcomes of ovarian cancer and ovarian cancer prevention. However, most of the evidence was observational studies. There is a call for further well-conducted controlled clinical trials to confirm the effects of metformin on ovarian cancer survival and ovarian cancer prevention.
有报道称二甲双胍对多种癌症具有潜在的治疗作用。然而，二甲双胍对卵巢癌影响的证据仍然有限且尚无定论。本系统评价和荟萃分析旨在总结二甲双胍治疗卵巢癌的现有证据。
我们使用电子数据库（包括 PubMed 和 EMBASE）进行了系统检索，检索时间截至 2012 年 12 月。关键词包括“二甲双胍”和（“卵巢癌”或“卵巢肿瘤”）。所有评估二甲双胍对卵巢癌影响的人类研究均符合纳入标准。所有文章均由 2 位作者独立进行审查，采用标准化方法评估研究、研究设计、患者特征、暴露和结局。使用随机效应模型对数据进行汇总。
在检索到的 190 项研究中，仅有 3 项观察性研究和 1 项 2 项随机对照试验的报告符合纳入标准。其中 2 项研究报告了二甲双胍对卵巢癌生存结局的影响，另外 2 项研究报告了二甲双胍对卵巢癌预防的影响。报告生存结局影响的研究结果表明，二甲双胍可能延长卵巢癌患者的总生存、疾病特异性生存和无进展生存。报告二甲双胍预防卵巢癌作用的研究结果进行了荟萃分析。结果表明，二甲双胍可能降低糖尿病患者卵巢癌的发生风险，合并的优势比为 0.57（95%置信区间，0.16-1.99）。
我们的研究结果表明二甲双胍对卵巢癌生存结局和卵巢癌预防具有潜在的治疗作用。然而，大部分证据是观察性研究。因此，需要进一步开展精心设计的对照临床试验来确认二甲双胍对卵巢癌生存和卵巢癌预防的作用。
