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Metformin associated with improved survival in patients with diabetes, pancreatic cancer
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The use of metformin, one of the most commonly used antidiabetic drugs, is associated with a longer survival rate in patients with pancreatic cancer, according to data from a retrospective study.
Navid Sadeghi, MD, and researchers at The University of Texas MD Anderson Cancer Center collected diabetes history, including treatment modalities and clinical outcome of pancreatic cancer, from 302 participants. The average age at cancer diagnosis was 64 years (65.6% men, 78.5% non-Hispanic white).
“Metformin use was associated with a 32% reduction in the risk of death and the association remained statistically significant after adjusting for other clinical predictors and after excluding insulin users,” the researchers wrote.
There were no significant differences in demographic or major clinical characteristics between the participants who received metformin (n=117) and those who did not (n=185), the researchers wrote.
Of the 302 participants, 240 (80%) died as of May 2011. Sixty-seven participants (22%) had resectable tumors, 124 (41%) had locally advanced disease and 111 (37%) had metastatic disease.
The overall 1-year survival rate was 53% for all disease stages combined, 63.9% for the metformin group and 46.3% for the non-metformin group (P=.002).
The overall 2-year survival rate was 21% for all participants, 30.1% for the metformin group and 15.4% for the non-metformin group (P=.004). The median overall survival time was 15.2 months for the metformin group and 11.1 months for the non-metformin group (P=.004).
Researchers concluded that metformin users had a 32% lower risk of death (HR=0.68; 95% CI, 0.52-0.89) in a univariate model, after adjusting for other clinical predictors (HR=0.64; 95% CI, 0.48-0.86) and after excluding insulin users (HR=0.62; 95% CI, 0.44-0.87).
In an accompanying editorial, Michael Pollak, MD, said these findings are receiving favorable attention, but more data concerning mechanism, pharmacokinetics and predictors of efficacy must be studied before metformin can be indicated for oncology patients.
“In sum, we have clinical, pharmacologic, and biologic clues concerning potential roles for biguanides in cancer prevention or treatment and hypotheses concerning both host and tumor characteristics that may identify situations where these drugs are most likely to be of value,” Pollak wrote. “Clinical trials that simply use metformin at antidiabetic doses in unselected cancer patients may or may not reveal benefit, so carefully designed preclinical and clinical studies are needed for rigorous investigation of important details.”
For more information:
- Pollak M. Clin Cancer Res . 2012;doi:10.1158/1078-0432.CCR-12-0694.
- Pollak M. Clin Cancer Res . 2012;doi:10.1158/1940-6207.CAPR-12-0080.
- Sadeghi N. Clin Cancer Res. 2012;doi:10.1158/1078-0432.CCR-11-2994.
Disclosure: The researchers report no relevant financial disclosures.