Oncology Center, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Wujiang, Jiangsu Province, P.R. China.
Department of Endocrinology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Wujiang, Jiangsu Province, P.R. China.
Medicine (Baltimore). 2022 Dec 9;101(49):e31799. doi: 10.1097/MD.0000000000031799.
Experiments have shown that metformin can inhibit cancer cell growth, but clinical observations have been inconsistent, so we pooled the currently available data to evaluate the impact of metformin on cancer survival and progression.
PubMed, web of science, Embase, and Cochrane databases were searched. Pooled hazard ratios (HRs) were identified using a random-effects model to estimate the strength of the association between metformin and survival and progression in cancer patients.
We incorporated 80 articles published from all databases which satisfied the inclusion criterion. It showed that metformin was associated with better overall survival (hazard ratio [HR] = 0. 81; 95% confidence interval [CI]: [0.77-0.85]) and cancer-specific survival (HR = 0.79; 95% CI: [0.73-0.86]), and metformin was associated with progression-free survival (HR = 0.76; 95% CI: [0.66-0.87]). In patients with diabetes mellitus, the HR of overall survival was 0.79(95% CI: [0.75-0.83]), progression-free survival was 0.72(95% CI: [0.60-0.85]), and the cancer-specific survival was 0.76(95% CI: [0.68-0.86]). It was proposed that metformin can improve the prognosis of cancer patients with diabetes mellitus.
Based on cohort studies, metformin therapy has potential survival benefits for patients with malignancy, especially with the greatest benefits seen in breast cancer on overall survival, progression-free survival, and cancer-specific survival. And metformin also showed potential benefits in cancer-specific survival in colorectal and prostate cancer.
实验表明二甲双胍可以抑制癌细胞生长，但临床观察结果并不一致，因此我们汇总了目前可用的数据来评估二甲双胍对癌症患者生存和进展的影响。
检索 PubMed、web of science、Embase 和 Cochrane 数据库。使用随机效应模型确定汇总风险比（HR），以评估二甲双胍与癌症患者生存和进展之间的关联强度。
我们纳入了满足纳入标准的来自所有数据库的 80 篇文章。结果表明，二甲双胍与总生存（风险比 [HR] = 0.81；95%置信区间 [CI]：[0.77-0.85]）和癌症特异性生存（HR = 0.79；95% CI：[0.73-0.86]）相关，并且与无进展生存相关（HR = 0.76；95% CI：[0.66-0.87]）。在患有糖尿病的患者中，总生存的 HR 为 0.79（95% CI：[0.75-0.83]），无进展生存的 HR 为 0.72（95% CI：[0.60-0.85]），癌症特异性生存的 HR 为 0.76（95% CI：[0.68-0.86]）。提出二甲双胍可以改善患有糖尿病的癌症患者的预后。
基于队列研究，二甲双胍治疗对恶性肿瘤患者具有潜在的生存获益，特别是在乳腺癌的总生存、无进展生存和癌症特异性生存方面获益最大。二甲双胍在结直肠癌和前列腺癌的癌症特异性生存方面也显示出潜在的获益。
