R-H Tian1, Y-G Zhang2, Z Wu3, X Liu4, J-W Yang1, H-L Ji5. 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. 2. Department of Respiratory, Shouguang People's Hospital, Shouguang, 262700, Shandong, People's Republic of China. 3. 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. zhenwu2210@126.com. 4. 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. xialiu79@126.com. 5. Department of Medical Affairs, Affiliated Haian People's Hospital of Nantong University, Haian, 226600, Jiangsu, People's Republic of China.
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.
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 diabetespatients 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 cancerpatients with type 2 diabetes but the effect was modest. However, it could achieve benefits in a selective sub-group of lung cancerpatients especially in SCLCpatients from Asian. Further studies are warranted to confirm this efficacy.
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