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钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂与非小细胞肺癌患者生存。

Sodium-glucose cotransporter 2 (SGLT2) inhibitors and non-small cell lung cancer survival.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA.

Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA.

出版信息

Br J Cancer. 2023 Apr;128(8):1541-1547. doi: 10.1038/s41416-023-02177-2. Epub 2023 Feb 10.

Abstract

BACKGROUND

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with demonstrated renal and cardiovascular disease benefit. This study evaluates the role of SGLT2 inhibitors on the survival of non-small cell lung cancer (NSCLC) patients.

METHODS

We used National Surveillance, Epidemiology and End Results (SEER)-Medicare linked data. Twenty four thousand nine hundred fifteen NSCLC patients newly diagnosed between 2014 and 2017 with pre-exiting diabetes and aged 66 years or older were included and followed to the end of 2019. Information on SGLT2 inhibitors use was extracted from the Medicare Part D file.

RESULTS

SGLT2 inhibitor use was associated with significantly reduced mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.60-0.77) with stronger association for longer duration of use (HR = 0.54, 85% CI = 0.44-0.68). Further, we found that SGLT2 inhibitor use was associated with a significant reduced risk of mortality regardless of patients' demographic, tumour characteristics and cancer treatments.

CONCLUSION

Our large SEER-Medicare linked data study indicates that SGLT2 inhibitors use was associated with improved overall survival of NSCLC patients with pre-existing diabetes. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association.

摘要

背景

钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂是一类新型的抗糖尿病药物,已证实具有肾脏和心血管疾病获益。本研究评估 SGLT2 抑制剂对非小细胞肺癌(NSCLC)患者生存的影响。

方法

我们使用了国家监测、流行病学和最终结果(SEER)-医疗保险关联数据。纳入了 2014 年至 2017 年间新诊断为 NSCLC、年龄在 66 岁或以上且有既往糖尿病的 24915 例患者,并随访至 2019 年底。SGLT2 抑制剂的使用信息从医疗保险部分 D 文件中提取。

结果

在调整了潜在混杂因素后,SGLT2 抑制剂的使用与死亡率风险显著降低相关(HR=0.68,95%CI=0.60-0.77),且使用时间越长关联越强(HR=0.54,95%CI=0.44-0.68)。此外,我们发现无论患者的人口统计学、肿瘤特征和癌症治疗如何,SGLT2 抑制剂的使用都与死亡率风险显著降低相关。

结论

我们的大型 SEER-医疗保险关联数据研究表明,SGLT2 抑制剂的使用与患有既往糖尿病的 NSCLC 患者的总体生存率提高有关。需要进一步的研究来证实我们的发现,并阐明这种关联背后的可能机制。

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