Cancer 2011 Nov;117 (22): 5103-11. [IF:5.131]
Prognostic influence of metformin as first-line chemotherapy for advanced nonsmall cell lung cancer in patients with type 2 diabetes.
Tan BX , Yao WX , Ge J , Peng XC , Du XB , Zhang R , Yao B , Xie K , Li LH , Dong H , Gao F , Zhao F , Hou JM , Su JM , Liu JY .
Department of Medical Oncology, Cancer Center, the State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
四川大学华西医院生物治疗国家重点实验室
Abstract
It has been reported that antidiabetic drugs affect the risk of cancer and the prognosis of patients with diabetes, but few studies have demonstrated the influence of different antidiabetic agents on outcomes after anticancer therapy among patients with cancer. The objective of this study was to evaluate the influence of the antidiabetic drugs metformin and insulin on the prognosis of patients with advanced nonsmall cell lung cancer (NSCLC) plus type 2 diabetes who received first-line chemotherapy. Data on patients with NSCLC who had diabetes from 5 hospitals in China during January 2004 to March 2009 were reviewed retrospectively. Ninety-nine patients were included in the final analysis. The influence of metformin and insulin on chemotherapy response rates and survival in these patients was evaluated. Chemotherapy with metformin (Group A) produced superior results compared with insulin (Group B) and compared with drugs other than metformin and insulin (Group C) in terms of both progression-free survival (PFS) (8.4 months vs 4.7 months vs 6.4 months, respectively; P = .002) and overall survival (OS) (20.0 months vs 13.1 months vs 13.0 months, respectively; P = .007). Although no significant differences in the response rate (RR) were observed between these 3 groups, when groups B and C (ie, the nonmetformin group) were combined, there was a tendency for better disease control in Group A than that in nonmetformin group. No significant difference in survival was observed between chemotherapy with insulin (Group B) versus other drugs (Group C). The current data suggested that metformin may improve chemotherapy outcomes and survival for patients who have NSCLC with diabetes. Cancer 2011;. ? 2011 American Cancer Society.
摘要：
既往研究发现抗糖药影响癌症风险和糖尿病患者预后，但抗糖药对使用化疗药后的癌症患者的影响的研究较少。此项研究的目的在于评价抗糖药二甲双胍和胰岛素对接受一线化疗后的非小细胞肺癌合并2型糖尿病患者的预后的影响。研究数据是来自2004年一月至2009年三月间中国5所医院的非小细胞肺癌合并2型糖尿病患者。99位患者参与了最终的分析。研究评价了二甲双胍和胰岛素对这些患者的化疗反应率和生存率的影响。从疾病无进展生存时间和总生存率两个指标上看，A组（化疗+二甲双胍组）优于B组（化疗+胰岛素组）和C组（化疗+除二甲双胍和胰岛素外的其他药物组），疾病无进展生存时间分别为8.4月比4.7月比6.4月，P=0.002，总生存率分别为20.0月比13.1月比13.0月，P=0.007。尽管三组间的反应率没有明显差别，但将B组和C组（即不含二甲双胍组）合并后，发现A组（含二甲双胍组）对疾病的控制情况更好。B组（化疗+胰岛素组）与C组（化疗+除二甲双胍和胰岛素外的其他药物组）在生存率上无明显差异。这些结果表明二甲双胍有可能改善非小细胞肺癌合并2型糖尿病患者的化疗效果。
