Metformin Prolongs Survival in Type 2 Diabetes Lung Cancer Patients With EGFR-TKIs

Integr Cancer Ther. Jan-Dec 2019;18:1534735419869491. doi: 10.1177/1534735419869491.

Abstract

Background: Metformin use reportedly reduces cancer risk and improves survival in lung cancer patients. This study aimed to investigate the effect of metformin use in patients with diabetes mellitus (DM) and lung cancer receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. Methods: A nationwide, population-based cohort study was conducted using the Taiwan National Health Insurance Research Database. From January 1, 2004, to December 31, 2012, a total of 373 metformin and 1260 non-metformin lung cancer cohorts with type 2 DM and EGFR-TKI treatment were studied. Results: Metformin use was significantly associated with a reduced risk of death (hazard ratio: 0.73, 95% confidence interval [CI]: 0.62-0.85, P < .001), as well as a significantly longer median progression-free survival (9.2 months, 95% CI: 8.6-11.7, vs 6.4 months, 95% CI: 5.9-7.2 months, P < .001) and median overall survival (33.4 months, 95% CI: 29.4-40.2, vs 25.4 months, 95% CI: 23.7-27.2 months, P < 0.001). Conclusions: In conclusion, metformin may potentially enhance the therapeutic effect and increase survival in type 2 DM patients with lung cancer receiving EGFR-TKI therapy.

Keywords: DM; EGFR; TKI; lung cancer; metformin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / mortality*
  • Disease-Free Survival
  • ErbB Receptors / metabolism
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality*
  • Male
  • Metformin / therapeutic use*
  • Middle Aged
  • Protein Kinase Inhibitors / therapeutic use*
  • Taiwan

Substances

  • Hypoglycemic Agents
  • Protein Kinase Inhibitors
  • Metformin
  • EGFR protein, human
  • ErbB Receptors