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Meta-Analysis
. 2013;18(12):1248-55.
doi: 10.1634/theoncologist.2013-0111. Epub 2013 Nov 20.

Metformin is associated with survival benefit in cancer patients with concurrent type 2 diabetes: a systematic review and meta-analysis

Ming Yin  1 , Jie Zhou, Edward J Gorak, Fahd Quddus
Affiliations
Meta-Analysis

Metformin is associated with survival benefit in cancer patients with concurrent type 2 diabetes: a systematic review and meta-analysis

Ming Yin et al. Oncologist. 2013.

Abstract

Patients with type 2 diabetes have increased cancer risk and cancer-related mortality, which can be reduced by metformin treatment. However, it is unclear whether metformin can also modulate clinical outcomes in patients with cancer and concurrent type 2 diabetes.

Patients and methods: A meta-analysis of 20 publications that included 13,008 subjects was performed to investigate the association between metformin and overall survival (OS) as well as cancer-specific survival (CSS) in patients with cancer and concurrent type 2 diabetes.

Results: We found that there was a relative survival benefit associated with metformin treatment compared with treatment with other glucose-lowering medications in both OS and CSS (hazard ratio [HR] = 0.66; 95% confidence interval [CI]: 0.55-0.79 and HR = 0.62; 95% CI: 0.46-0.84, respectively). These associations were also observed in subgroups by cancer type and country.

Conclusion: These results suggest that metformin is the drug of choice in the treatment of patients with cancer and concurrent type 2 diabetes.

Keywords: Cancer; Diabetes; Meta-Analysis; Metformin; Survival.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1.
Figure 1.
Study flow chart for the process of selecting the final 20 publications. Abbreviations: OS, overall survival.
Figure 2.
Figure 2.
Hazard ratios (HRs) of overall survival by metformin versus non-metformin exposure. For each study, the estimates of HR and 95% CI were plotted with a box and a horizontal line. Closed diamond indicates pooled HR and 95% CI. Abbreviations: CI, confidence interval; df, degrees of freedom.
Figure 3.
Figure 3.
Funnel plot analysis to detect publication bias. Each circle represents an individual study for the indicated association. Hollow circles indicate original observation studies; solid circles indicate missing studies by trim and fill method. Abbreviation: s.e., standard error.
See this image and copyright information in PMC

Comment in

References

    1. Richardson LC, Pollack LA. Therapy insight: Influence of type 2 diabetes on the development, treatment and outcomes of cancer. Nat Clin Prac. 2005;2:48–53. - PubMed
    1. Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: A consensus report. Diabetes Care. 2010;33:1674–1685. - PMC - PubMed
    1. Foretz M, Hebrard S, Leclerc J, et al. Metformin inhibits hepatic gluconeogenesis in mice independently of the lkb1/ampk pathway via a decrease in hepatic energy state. J Clin Invest. 2010;120:2355–2369. - PMC - PubMed
    1. Kim YD, Park KG, Lee YS, et al. Metformin inhibits hepatic gluconeogenesis through amp-activated protein kinase-dependent regulation of the orphan nuclear receptor shp. Diabetes. 2008;57:306–314. - PubMed
    1. Staels B. Metformin and pioglitazone: Effectively treating insulin resistance. Curr Med Res Opin. 2006;22(Suppl 2):27–37. - PubMed

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