Effects of metformin on endometrial cancer: Systematic review and meta-analysis.

Autor: Meireles CG; Molecular Pharmacology Laboratory, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil., Pereira SA; Molecular Pharmacology Laboratory, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil., Valadares LP; Molecular Pharmacology Laboratory, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil; Gonadal and Adrenal Diseases Clinics, University Hospital of Brasilia, University of Brasilia, Brasilia, Brazil., Rêgo DF; Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil., Simeoni LA; Molecular Pharmacology Laboratory, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil., Guerra ENS; Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil., Lofrano-Porto A; Molecular Pharmacology Laboratory, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil; Gonadal and Adrenal Diseases Clinics, University Hospital of Brasilia, University of Brasilia, Brasilia, Brazil. Electronic address: adlofrano@uol.com.br.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2017 Oct; Vol. 147 (1), pp. 167-180. Date of Electronic Publication: 2017 Jul 29.
DOI: 10.1016/j.ygyno.2017.07.120
Abstrakt: Background: Endometrial cancer is one of the most common gynecological cancers, which is frequently preceded by atypical endometrial hyperplasia, a premalignant lesion. Metformin, an antidiabetic drug, has emerged as a new adjunctive strategy for different cancer types, including endometrial cancer. This systematic review and meta-analysis aimed to evaluate the effects of metformin in atypical endometrial hyperplasia and endometrial cancer patients.
Methods: The search was conducted on January 2017 and the articles were collected in Cochrane, LILACS, PubMed, Scopus and Web of Science. A grey literature search was undertaken using Google SCHOLAR, ProQuest and Open Grey. Nineteen studies were included, which contained information about the following outcomes: reversal of atypical endometrial hyperplasia, cellular proliferation biomarkers expression and overall survival in metformin-users compared to non-users.
Results: Metformin was associated with reversion of atypical endometrial hyperplasia to a normal endometrial, and with decreased cell proliferation biomarkers staining, from 51.94% (CI=36.23% to 67.46%) to 34.47% (CI=18.55% to 52.43%). However, there is a high heterogeneity among studies. Metformin-users endometrial cancer patients had a higher overall survival compared to non-metformin users and non-diabetic patients (HR=0.82; CI: 0.70-0.95; p=0.09, I 2 =40%).
Conclusion: Regardless the high heterogeneity of the analyzed studies, the present review suggests that adjunct metformin treatment may assist in the reversal of atypical endometrial hyperplasia to normal endometrial histology, in the reduction of cell proliferation biomarkers implicated in tumor progression, and in the improvement of overall survival in endometrial cancer. Further work on prospective controlled trials designed to address the effects of adjunct metformin on clinical outcomes is necessary for definite conclusions.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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