Liu Chen-Qian, Sun Jian-Xuan, Xu Jin-Zhou, Qian Xiao-Yuan, Hong Sen-Yuan, Xu Meng-Yao, An Ye, Xia Qi-Dong, Hu Jia, Wang Shao-Gang
Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Pharmacol. 2022 Apr 7;13:865988. doi: 10.3389/fphar.2022.865988. eCollection 2022.
The incidence rate and mortality of bladder cancer are increasing year by year. Interestingly, the commonly used metabolic regulatory drug metformin has been reported to have anti-tumor effect in recent years. Nevertheless, it keeps unclear whether the usage of metformin is beneficial or unbeneficial in treating bladder cancer. Thus, a meta-analysis was conducted to explore the long-term effect of metformin on the incidence of bladder cancer and OS, PFS, DSS and RFS in bladder cancer patients with T2DM. We aim to collect evidence of the association between the usage of metformin and the incidence and treatment outcome of bladder cancer. We searched PubMed, Embase, Ovid Medline and Cochrane Library up to February 2021 to get effective literature reporting the effects of metformin in bladder cancer. The main outcomes were the protective effects of metformin on the incidence, overall survival (OS), recurrence-free survival (RFS), progression-free survival (PFS), and disease-specific survival (DSS) of bladder cancer. And OR (odds ratio) and HR (hazard ratio) with their 95%CI were pooled. Two independent researchers assessed the quality of included studies using the Newcastle-Ottawa Scale (NOS). We involved 12 studies meeting the inclusion criteria, including a total of 1,552,773 patients. The meta-analysis showed that use of metformin could decrease the incidence (OR = 0.45, 95%CI = 0.37-0.56; < 0.01) and prolong recurrence-free-survival (HR = 0.56, 95%CI = 0.41-0.76; = 0.91) of bladder cancer. However, there were no significant protective effects in the overall survival (HR = 0.93, 95%CI = 0.67-1.28, = 0.05), disease-specific-survival (HR = 0.73, 95%CI = 0.47-1.16; = 0.01), and progression-free-survival (HR = 0.78, 95%CI = 0.53-1.15, = 0.34). The results revealed that the usage of metformin could reduce the incidence of bladder cancer and prolong the prognosis of bladder cancer in T2DM patients, respectively. More prospective studies are needed to prove the protective role of metformin on bladder cancer.
膀胱癌的发病率和死亡率逐年上升。有趣的是，近年来有报道称常用的代谢调节药物二甲双胍具有抗肿瘤作用。然而，二甲双胍在治疗膀胱癌中是有益还是有害仍不清楚。因此，进行了一项荟萃分析，以探讨二甲双胍对T2DM膀胱癌患者膀胱癌发病率以及总生存期（OS）、无进展生存期（PFS）、疾病特异性生存期（DSS）和无复发生存期（RFS）的长期影响。我们旨在收集二甲双胍的使用与膀胱癌发病率和治疗结果之间关联的证据。我们检索了截至2021年2月的PubMed、Embase、Ovid Medline和Cochrane图书馆，以获取报道二甲双胍对膀胱癌影响的有效文献。主要结局是二甲双胍对膀胱癌发病率、总生存期（OS）、无复发生存期（RFS）、无进展生存期（PFS）和疾病特异性生存期（DSS）的保护作用。并汇总了比值比（OR）和风险比（HR）及其95%置信区间（CI）。两名独立研究人员使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。我们纳入了12项符合纳入标准的研究，共1,552,773例患者。荟萃分析表明，使用二甲双胍可降低膀胱癌的发病率（OR = 0.45，95%CI = 0.37 - 0.56；<0.01）并延长无复发生存期（HR = 0.56，95%CI = 0.41 - 0.76；= 0.91）。然而，在总生存期（HR = 0.93，95%CI = 0.67 - 1.28，= 0.05）、疾病特异性生存期（HR = 0.73，95%CI = 0.47 - 1.16；= 0.01）和无进展生存期（HR = 0.78，95%CI = 0.53 - 1.15，= 0.34）方面没有显著的保护作用。结果表明，二甲双胍的使用可以分别降低T2DM患者膀胱癌的发病率并延长膀胱癌的预后。需要更多的前瞻性研究来证明二甲双胍对膀胱癌的保护作用。
