Metformin may improve outcomes in diffuse large B-cell lymphoma
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The addition of metformin to standard chemotherapy improved outcomes for patients with diffuse large B-cell lymphoma, according to findings presented at Society of Hematologic Oncology Annual Meeting.
The regimen did not lead to additional toxicity, results showed.
“Further studies with large numbers and subgroup analysis for certain types of DLBCL are needed,” Hagar Alagizy, MD, professor of clinical oncology at Menoufia University in Egypt, and colleagues wrote.
Prior research showed metformin may possess antitumor activity against various cancer types. Evidence also suggests metformin use may be associated with better outcomes among patients with different types of solid tumors, according to study background.
Alagizy and colleagues assessed whether the addition of metformin to standard first-line chemotherapy improved outcomes for patients with DLBCL.
Toxicity and response rate served as the primary endpoints. Secondary endpoints included DFS and OS.
The analysis included 100 patients who started treatment between January 2021 and September 2022.
Half received only R-CHOP, which consists of rituximab 375 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 750 mg/m2, vincristine 2 mg and prednisolone 100 mg for 5 days.
The other half received R-CHOP plus metformin dosed at 1,000 mg twice daily in uninterrupted 3-week cycles. The dose increased in 500-mg steps within 2 weeks to the target dose continuously, with treatment continuing until disease progression, unacceptable drug toxicity or patient withdrawal.
A higher percentage of patients who received metformin plus R-CHOP achieved complete remission at first restaging (56% vs. 32%; P = 0.016) and complete remission at the end of treatment (94% vs. 66%; P = .001).
Researchers reported lower rates of relapse/progression (6% vs. 54%; P < .001) and overall mortality (4% vs. 24%; P = .004) in the metformin group.
A higher percentage of patients who received metformin experienced nausea (32% vs. 14%; P = .032). The differences in rates of other adverse events — such as anemia, neutropenia, diarrhea, thrombocytopenia, hypoglycemia, mucositis, vomiting or metallic taste — did not reach statistical significance.
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Alagizy H, et al. Abstract ABCL-039. Presented at: Society of Hematologic Oncology Annual Meeting; Sept. 6-9, 2023; Houston.
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