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The effect of metformin on gastric cancer in patients with type 2 diabetes: a systematic review and meta-analysis

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Abstract

Background

Metformin, a drug widely used in the treatment of diabetes, has proven preventive and survival benefits for various malignancies. However, the effect of metformin on gastric cancer risk and survival rate in T2DM patients remains controversial. Therefore, we conducted a systematic review and meta-analysis to evaluate the effect of metformin on gastric cancer in T2DM patients.

Methods

We searched PubMed, EMBASE, Medline and the Cochrane Library for related studies up to October 22, 2019. Pooled hazard ratios with 95% confidence intervals were calculated using random-effects model. Heterogeneity was assessed. All articles were evaluated by Newcastle–Ottawa Scale.

Results

A total of 11 cohort studies met eligibility criteria and were included in the meta-analysis. The use of metformin was related to a significant 21% reduction in GC incidence (HR 0.790; 95% CI 0.624–1.001). Subgroup analysis showed that the use of metformin significantly reduced the risk of gastric cancer in T2DM patients in Asian populations, but not in western populations. In a pooled analysis of 3 studies, metformin use was associated with increased overall survival rate (HR 0.817; 95% CI 0.600–1.113) and cancer-specific survival rate (HR 0.824; 95% CI 0.614–1.106) of T2DM patients.

Conclusions

Metformin could reduce the risk of gastric cancer in T2DM patients, particularly in Asian populations. However, it is debatable whether metformin use can improve the prognosis of gastric cancer in T2DM patients.

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Author notes

  1. Y. Shuai and C. Li contributed equally to the writing of this article.

Authors and Affiliations

  1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Road, Donghu District, Nanchang, 330006, Jiangxi, People’s Republic of China

    Y. Shuai, C. Li & X. Zhou

  2. First Clinical Medical College, Nanchang University, Nanchang, 330006, People’s Republic of China

    Y. Shuai & C. Li

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Correspondence to X. Zhou.

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Shuai, Y., Li, C. & Zhou, X. The effect of metformin on gastric cancer in patients with type 2 diabetes: a systematic review and meta-analysis. Clin Transl Oncol 22, 1580–1590 (2020). https://doi.org/10.1007/s12094-020-02304-y

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