二甲双胍对晚期或不可切除癌症患者无显著抗癌作用：系统评价和荟萃分析。

Metformin has no Significant Anticancer Effect on Patients with Advanced or Unresectable Cancer: A Systematic Review and Meta-analysis.

机构信息

State Key Laboratory of Oral Diseases, West China Hospital of Stomatology/Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

出版信息

Curr Pharm Des. 2022;28(16):1351-1358. doi: 10.2174/1381612828666220329113434.

DOI:10.2174/1381612828666220329113434

PMID:35352646

Abstract

BACKGROUND

At present, the antitumor effect of metformin is controversial. Previous meta-analyses included observational studies, of which the results can be influenced by many confounders, affecting the result of meta-analyses and weakening the strength of evidence. Therefore, we conducted a meta-analysis to confirm the effect of metformin use on patients with advanced or unresectable cancers, including randomized clinical trials (RCTs).

METHODS

We searched for RCTs in accordance with the inclusion and exclusion criteria. A meta-analysis was conducted to combine hazard ratios (HRs) or risk ratios (RRs) and their 95% confidence intervals (CIs) using a random-effects model.

RESULTS

Finally, 7 eligible RCTs were included in the meta-analysis. Overall, the combined results revealed that treatment with metformin did not improve the overall survival (OS) of patients (HR, 1.12; 95% CI, 0.91-1.37, p>0.05), and there was no clear evidence that metformin use was related to improved progression-free survival (PFS) (HR, 1.17; 95% CI, 0.97-1.40; p>0.05). The pooled RR for grade III or IV adverse events was 0.92 (95% CI, 0.52- 1.60; p>0.05), indicating that the use of metformin was not significantly related to increased toxicity.

CONCLUSION

Metformin does not significantly improve the survival of patients with advanced or unresectable cancer, regardless of cancer type and region.

摘要

背景

目前，二甲双胍的抗肿瘤作用存在争议。先前的荟萃分析纳入了观察性研究，其结果可能受到许多混杂因素的影响，从而影响荟萃分析的结果并削弱证据的力度。因此，我们进行了一项荟萃分析，以确认二甲双胍的使用对晚期或不可切除癌症患者的影响，包括随机对照试验（RCT）。

方法

我们按照纳入和排除标准搜索 RCT。使用随机效应模型对风险比（HR）或风险比（RR）及其 95％置信区间（CI）进行荟萃分析。

结果

最终，7 项符合条件的 RCT 被纳入荟萃分析。总体而言，联合结果表明，二甲双胍治疗并未改善患者的总生存期（OS）（HR，1.12；95％CI，0.91-1.37，p＞0.05），并且没有明确证据表明二甲双胍的使用与无进展生存期（PFS）的改善有关（HR，1.17；95％CI，0.97-1.40；p＞0.05）。III 级或 IV 级不良事件的汇总 RR 为 0.92（95％CI，0.52-1.60；p＞0.05），表明二甲双胍的使用与毒性增加无关。