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. 2021 Mar;124(5):1018-1025.
doi: 10.1038/s41416-020-01186-9. Epub 2020 Dec 2.

Metformin use and lung cancer survival: a population-based study in Norway

Suzan Brancher #  1 , Nathalie C Støer #  2   3 , Elisabete Weiderpass  4 , Ronald A M Damhuis  5 , Tom B Johannesen  3 , Edoardo Botteri  3 , Trond-Eirik Strand  3
Affiliations

Metformin use and lung cancer survival: a population-based study in Norway

Suzan Brancher et al. Br J Cancer. 2021 Mar.

Abstract

Background: We assessed associations between metformin use and survival in a nationwide Norwegian cohort of lung cancer (LC) patients.

Methods: The study linked 22,324 LC patients from the Cancer Registry of Norway diagnosed 2005-2014 with the Norwegian Prescription Database. We estimated associations of pre- and post-diagnostic metformin use with overall survival (OS) and LC-specific survival (LCSS) using multivariable time-fixed and time-dependent Cox regression.

Results: Pre-diagnostic metformin use was not associated with improved survival in all patients. Nevertheless, pre-diagnostic metformin use was associated with better LCSS in squamous cell carcinoma (SCC) patients (hazard ratio (HR) = 0.79; 95% confidence interval (CI) 0.62-0.99) and in patients with regional stage SCC (HR = 0.67; 95%CI 0.47-0.95). Post-diagnostic metformin use was associated with improved LCSS in all patients (HR = 0.83; 95%CI 0.73-0.95), in patients with SCC (HR = 0.75; 95%CI 0.57-0.98), regional stage LC (HR = 0.74; 95%CI 0.59-0.94), and regional stage SCC (HR = 0.57; 95%CI 0.38-0.86). OS showed similar results. Analyses of cumulative use showed a dose-response relationship in all patients, patients with adenocarcinoma and SCC, and with regional and metastatic LC.

Conclusions: Metformin use was associated with improved survival, especially LCSS in patients with regional stage SCC. Further prospective studies are required to clarify the role of metformin in LC treatment.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Kaplan–Meier curves for overall survival.
Asterisk indicates metformin versus no use. Double asterisk metformin versus any other anti-diabetic medication.
See this image and copyright information in PMC

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