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2018 ; 7
(3
): 389-396
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gab.com Text
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The prognostic value of metformin for advanced non-small cell lung cancer: a
systematic review and meta-analysis
#MMPMID30050776
Zhang J
; Wu J
; He Q
; Liang W
; He J
Transl Lung Cancer Res
2018[Jun]; 7
(3
): 389-396
PMID30050776
show ga
BACKGROUND: The prognostic value of Metformin for concurrent non-small cell lung
cancer (NSCLC) has been controversial in previous individual studies and
meta-analyses. In order to further investigate the value of this medication, we
conducted a systematic review and meta-analysis for patients with advanced or
inoperable NSCLC. METHODS: We searched articles from PubMed, Scopus and Web of
Science databases; the time interval was from the inception date of the databases
to 1 September 2017. Inclusion criteria for eligible studies were: advanced or
inoperable NSCLC; Metformin as an experimental group, and non-Metformin usage as
a control group; progression-free survival (PFS) or overall survival (OS) as the
outcome, with available hazard ratio (HR). Data synthesis was conducted based on
the random-effect model. RESULTS: From a total of 97 articles in databases, we
included seven eligible studies. Among them, only one study compared Metformin
usage and non-Metformin usage for NSCLC patients who didn't have diabetes
mellitus (DM): no significant difference was found in either OS or PFS. The
remaining six studies compared Metformin usage and non-Metformin usage for
patients with concurrent NSCLC and DM: according to meta-analysis, significantly
prolonged OS was found in Metformin usage rather than non-Metformin usage [pooled
HR =0.87 (0.77-0.99), P=0.04]; no significant difference was indicated in PFS
[pooled HR =0.85 (0.67-1.07), P=0.16]. In subgroup analysis, among patients with
late-stage NSCLC and DM, significant difference was found, regardless of OS
[pooled HR =0.81 (0.70-0.94), P<0.01] or PFS [pooled HR =0.71 (0.58-0.88),
P<0.01]. However, among patients with local advanced NSCLC and DM, there was no
significant difference [OS: pooled HR =1.05 (0.79-1.40), P=0.74; PFS: pooled HR
=0.94 (0.68-1.32), P=0.74]. CONCLUSIONS: The prognostic value of Metformin for
concurrent late-stage NSCLC and DM was demonstrated. It deserves further
confirmation and explanation.