Oncotarget

Clinical Research Papers:

Metformin therapy associated with survival benefit in lung cancer patients with diabetes

Guoxing Wan, Xiongjie Yu, Ping Chen, Xianhe Wang, Dongfeng Pan, Xuanbin Wang, Linjun Li, Xiaojun Cai and Fengjun Cao _

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Oncotarget. 2016; 7:35437-35445. https://doi.org/10.18632/oncotarget.8881

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Abstract

Guoxing Wan1, Xiongjie Yu1, Ping Chen1, Xianhe Wang1, Dongfeng Pan1, Xuanbin Wang1, Linjun Li1, Xiaojun Cai1 and Fengjun Cao1

1 Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China

Correspondence to:

Fengjun Cao, email:

Xiaojun Cai, email:

Keywords: lung cancer, metformin, survival, diabetes, meta-analysis

Received: October 29, 2015 Accepted: April 11, 2016 Published: April 20, 2016

Abstract

The purpose of this study is to summarize the currently available evidence regarding the concerned issue by performing a comprehensive meta-analysis. Relevant publications reporting the association of metformin use with survival of lung cancer patients with diabetes were electronically searched to identify eligible studies. The meta-analysis was performed with hazard ratios (HRs) and 95% confidence intervals (95% CIs) as effect measures for disease-free survival(DFS) and overall survival(OS) estimates. A total of 17 individual studies from 10 publications were included in the meta-analysis. Overall, the results revealed a significant association of metformin use with a better survival of lung cancer patients with diabetes(for DFS: HR = 0.65, 95%CI = 0.52-0.83; for OS: HR = 0.78, 95%CI = 0.64-0.93). The subgroup analyses showed similar association in Asian region(for DFS:HR = 0.69, 95%CI = 0.59-0.80; for OS: HR = 0.55, 95%CI = 0.46-0.67) but not in Western region. Such association was also presented in small cell lung cancer (for DFS: HR = 0.54, 95%CI = 0.38-0.77; for OS: HR = 0.52, 95%CI = 0.39-0.69) and in non-small cell lung cancer(for DFS: HR = 0.70, 95%CI = 0.51-0.96; for OS: HR = 0.75, 95%CI = 0.58- 0.97). Analyses stratified by treatment strategy showed a reduction in the risk of cancer-related mortality in patients receiving chemotherapy(for DFS: HR = 0.71, 95%CI = 0.64-0.83; for OS: HR = 0.58, 95%CI = 0.47-0.71) but not in patients receiving chemoradiotherapy. The meta-analysis demonstrated that metformin use was significantly associated with a favorable survival outcome of lung cancer patients with diabetes.


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