Wen-Xiu Xin, Xiao-Wei Zheng, Hai-Ying Ding, Ying-Hui Tong, Si-Si Kong, Xiao-Fang Zhou, Huang Ping
Laboratory of Clinical Pharmacy.
Key Laboratory of Head and Neck Translational Research of Zhejiang Province Zhejiang Cancer Hospital, Hangzhou, P.R. China.
Medicine (Baltimore). 2018 Dec;97(51):e13652. doi: 10.1097/MD.0000000000013652.
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.
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。