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. 2018 Jan 12;13(1):e0191129.
doi: 10.1371/journal.pone.0191129. eCollection 2018.

Survival benefit associated with metformin use in inoperable non-small cell lung cancer patients with diabetes: A population-based retrospective cohort study

Min-Chun Chuang  1   2 , Yao-Hsu Yang  3   4   5 , Ying-Huang Tsai  6 , Meng-Jer Hsieh  1 , Yu-Ching Lin  1 , Chin-Kuo Lin  1 , Pau-Chung Chen  7   8 , Tsung-Ming Yang  1
Affiliations

Survival benefit associated with metformin use in inoperable non-small cell lung cancer patients with diabetes: A population-based retrospective cohort study

Min-Chun Chuang et al. PLoS One. .

Abstract

Objective: To evaluate the effects of metformin use on the survival of inoperable non-small cell lung cancer (NSCLC) patients with diabetes using the Taiwanese National Health Insurance Research Database.

Research design and methods: In total, 7,620 patients were eligible in this study, among them, 3,578 patients were metformin users and 4,042 were non-users. Propensity score matching was used to reduce possible confounding factors. In total, 4,182 patients (2,091 matched pairs) were included in the matched cohort. Cox proportional hazard model with time-dependent covariate were also applied to evaluate the association between metformin use and overall survival (OS).

Results: A total of 3,578 patients were metformin users at the time of diagnosis of NSCLC. Cox proportional hazard model with time-dependent covariate revealed that metformin use was associated with a significantly longer OS (HR: 0.85, 95.0% CI: 0.80-0.90). The survival benefit of metformin use was maintained after propensity score matching at a ratio of 1:1 (HR: 0.90, 95.0% CI: 0.84-0.97).

Conclusions: Metformin use is associated with longer OS in inoperable NSCLC patients with diabetes, suggesting a potential anti-tumorigenic effect for metformin. Further research is needed to investigate the actual role of metformin in the treatment of NSCLC patients with diabetes.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of patient selection from the Registry for Catastrophic Illness Patient Database (RCIPD).
ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; NSCLC, non-small cell lung cancer.
Fig 2
Fig 2. Subgroup analysis of adjusted hazard ratios (HRs) of risk factors for metformin-related mortality in the matched cohorts.
See this image and copyright information in PMC

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