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Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysis

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Abstract

Background

Anti-cancer effect of metformin on different kinds of lung cancer has been studied frequently. However, the association between metformin and the prognosis of lung cancer in type 2 diabetes patients is still controversial.

Methods

An electronic search was conducted using PubMed/Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity examined by I 2 statistics.

Results

Six studies involving 2350 patients were included in the current meta-analysis. In all, the pooled HR of overall survival (OS) was 0.90 (95 % CI 0.84–0.96; P = 0.003). Sub-group analysis showed that when stratified by region the HR of OS was 0.52 (95 % CI 0.31–0.87; P = 0.012) and 0.86 (95 % CI 0.67–1.11, P = 0.361) for Asian and Western countries. When stratified by study design, the HR of OS was 0.78 (95 % CI 0.52–1.15, P = 0.206) and 0.82 (95 % CI 0.59–1.16, P = 0.264) for cohort and medical data-based studies. When stratified by lung cancer subtype, HR of OS was 0.52 (95 % CI 0.31–0.87; P = 0.012), 1.06 (95 % CI 0.51–2.19; P = 0.878) and 0.82 (95 % CI 0.59–1.16; P = 0.264) for SCLS, NSCLC and non-divided subtypes, respectively.

Conclusion

Metformin use may associate with a good prognosis in lung cancer patients with type 2 diabetes but the effect was modest. However, it could achieve benefits in a selective sub-group of lung cancer patients especially in SCLC patients from Asian. Further studies are warranted to confirm this efficacy.

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Authors and Affiliations

  1. Department of Respiratory, Affiliated Haian People’s Hospital of Nantong University, 17 Cheng Zhong Ba Middle Road, Haian, 226600, Jiangsu, People’s Republic of China

    R.-H. Tian, Z. Wu, X. Liu & J.-W. Yang

  2. Department of Respiratory, Shouguang People’s Hospital, Shouguang, 262700, Shandong, People’s Republic of China

    Y.-G. Zhang

  3. Department of Medical Affairs, Affiliated Haian People’s Hospital of Nantong University, Haian, 226600, Jiangsu, People’s Republic of China

    H.-L. Ji

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  1. R.-H. Tian
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  4. X. Liu
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Correspondence to Z. Wu or X. Liu.

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Tian, RH., Zhang, YG., Wu, Z. et al. Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysis. Clin Transl Oncol 18, 641–649 (2016). https://doi.org/10.1007/s12094-015-1412-x

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  • DOI: https://doi.org/10.1007/s12094-015-1412-x

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