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

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

Hung MS1,2,3, Chuang MC1, Chen YC4,5, Lee CP6, Yang TM1,3,7, Chen PC8,9, Tsai YH1,10, Yang YH6,7,8,11.

Author information

1
1 Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi branch, Taiwan.
2
2 Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
3
3 Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan.
4
4 Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi branch, Taiwan.
5
5 Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan.
6
6 Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan.
7
7 Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi branch, Taiwan.
8
8 Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
9
9 Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
10
10 Department of Respiratory Care, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
11
11 School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

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

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