Hsu Chih-Wei, Zeng Bing-Syuan, Liang Chih-Sung, Zeng Bing-Yan, Hung Chao-Ming, Stubbs Brendon, Chen Yen-Wen, Lei Wei-Te, Chen Jiann-Jy, Chen Po-Huang, Su Kuan-Pin, Chen Tien-Yu, Tseng Ping-Tao
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan.
Int J Mol Sci. 2025 Aug 23;26(17):8202. doi: 10.3390/ijms26178202.
Metastatic cancer, characterized by poor survival outcomes and grim prognosis, represents the final stage of malignancy. The current evidence regarding the prophylactic effects of glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors on metastatic cancer remains largely unexamined. With a confirmatory approach based on the Cochrane recommendation, we conducted a frequentist-based network meta-analysis (NMA) of randomized controlled trials (RCTs) evaluating such medications. The primary outcome was the incidence of metastatic cancer, while secondary outcomes included safety profiles assessed through dropout rates. The findings were reaffirmed by sensitivity analysis with a Bayesian-based NMA. This NMA of 207,606 participants from 67 RCTs revealed that only efpeglenatide demonstrated a statistically significant reduction in metastatic cancer events compared to controls (odds ratio = 0.26, 95% confidence intervals = 0.09 to 0.70, = 0.010, number needed to treat = 188.4). Efpeglenatide's efficacy was not confined to specific cancer types. Safety profiles were comparable across all treatments. These findings indicate that efpeglenatide may possess a broad, systemic preventive effect against metastatic cancers, potentially operating through mechanisms that are not restricted to individual organ systems. Further research is warranted to elucidate the molecular pathways underlying its anti-metastatic properties and to explore its role in preventive oncology.
转移性癌症是恶性肿瘤的终末期，其生存结果较差且预后严峻。目前关于胰高血糖素样肽-1（GLP-1）受体激动剂和钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂对转移性癌症预防作用的证据仍基本未得到检验。我们采用基于Cochrane推荐的验证性方法，对评估此类药物的随机对照试验（RCT）进行了基于频率学派的网络荟萃分析（NMA）。主要结局是转移性癌症的发生率，次要结局包括通过脱落率评估的安全性概况。基于贝叶斯的NMA敏感性分析再次证实了这些发现。这项对来自67项RCT的207,606名参与者进行的NMA显示，与对照组相比，只有依帕列净在转移性癌症事件方面有统计学意义的显著降低（优势比=0.26，95%置信区间=0.09至0.70，P=0.010，需治疗人数=188.4）。依帕列净的疗效不限于特定癌症类型。所有治疗的安全性概况相当。这些发现表明，依帕列净可能对转移性癌症具有广泛的全身性预防作用，其潜在作用机制可能不限于个别器官系统。有必要进一步研究以阐明其抗转移特性的分子途径，并探索其在肿瘤预防中的作用。
