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二甲双胍的使用对接受铂类治疗的非小细胞肺癌生存结局的影响。

Impact of metformin use on survival outcomes in non-small cell lung cancer treated with platinum.

作者信息

Wen-Xiu Xin, Xiao-Wei Zheng, Hai-Ying Ding, Ying-Hui Tong, Si-Si Kong, Xiao-Fang Zhou, Huang Ping

机构信息

Laboratory of Clinical Pharmacy.

Key Laboratory of Head and Neck Translational Research of Zhejiang Province Zhejiang Cancer Hospital, Hangzhou, P.R. China.

出版信息

Medicine (Baltimore). 2018 Dec;97(51):e13652. doi: 10.1097/MD.0000000000013652.

Abstract

Preclinical evidence suggests that metformin, a widely used antidiabetic drug, may have a sensitizing effect on platinum. The purpose of this study was to evaluate the survival outcomes for non-small cell lung cancer (NSCLC) patients with type 2 diabetes mellitus (T2DM) using metformin during platinum-based chemotherapy.The clinicopathological parameters and survival data of 75 NSCLC patients with T2DM from January 2008 to December 2011 were collected and analyzed retrospectively. Patients were divided into 2 groups: metformin exposure group (n = 27) and non-metformin group (patients using other hypoglycemic agents or no drug for controlling n = 48). Univariate and multivariate analyses were performed to assess the association of metformin usage with overall survival (OS).Mean follow-up time was 58.7 months. The mean survival time was 36.74 months in the metformin group and 40.21 months in the non-metformin group. There was no significant difference in survival time between the 2 groups (P = .661). After adjusting gender, age, smoking status, tumor stage, tumor histology, and differentiation, multivariate analysis showed that metformin was not associated with the OS in NSCLC patients treated with concurrent platinum-based chemotherapy (hazard ratio: 1.071, 95% confidence interval: 0.577-1.986, P = .828).Our results indicated that metformin exposure had no significant effect on OS in NSCLC patients treated with platinum-based chemotherapy. Further studies are warranted to evaluate whether metformin could affect the survival of NSCLC patients treated with platinum-based chemotherapy.

摘要

临床前证据表明,二甲双胍这种广泛使用的抗糖尿病药物可能对铂具有增敏作用。本研究的目的是评估在铂类化疗期间使用二甲双胍的2型糖尿病(T2DM)非小细胞肺癌(NSCLC)患者的生存结局。回顾性收集并分析了2008年1月至2011年12月期间75例T2DM的NSCLC患者的临床病理参数和生存数据。患者分为2组:二甲双胍暴露组(n = 27)和非二甲双胍组(使用其他降糖药物或未使用药物控制血糖的患者,n = 48)。进行单因素和多因素分析以评估二甲双胍的使用与总生存期(OS)之间的关联。平均随访时间为58.7个月。二甲双胍组的平均生存时间为36.74个月,非二甲双胍组为40.21个月。两组之间的生存时间无显著差异(P = 0.661)。在调整性别、年龄、吸烟状况、肿瘤分期、肿瘤组织学和分化程度后,多因素分析显示,在接受同步铂类化疗的NSCLC患者中,二甲双胍与OS无关(风险比:1.071,95%置信区间:0.577 - 1.986,P = 0.828)。我们的结果表明,在接受铂类化疗的NSCLC患者中,二甲双胍暴露对OS无显著影响。有必要进一步研究评估二甲双胍是否会影响接受铂类化疗的NSCLC患者的生存情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c784/6320173/8c7204989636/medi-97-e13652-g003.jpg

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