Efficacy of Metformin in Patients With Breast Cancer Receiving Chemotherapy or Endocrine Therapy: Systematic Review and Meta-analysis
| Autor: | Yuki Kataoka, Nobuko Kawaguchi-Sakita, Akihiro Shiroshita, Yasuko Kurata, Kayoko Morio |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment Breast Neoplasms 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Humans Pharmacology (medical) In patient 030212 general & internal medicine Chemotherapy business.industry Endocrine therapy medicine.disease Metformin Neoadjuvant Therapy Chemotherapy Adjuvant 030220 oncology & carcinogenesis Meta-analysis Female Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | Annals of Pharmacotherapy. 56:245-255 |
| ISSN: | 1542-6270 1060-0280 |
| DOI: | 10.1177/10600280211025792 |
| Popis: | Background Previous studies have suggested that metformin might improve survival outcomes in patients with breast cancer. However, findings on the efficacy of metformin with chemotherapy or endocrine therapy are inconsistent. Objective To clarify the efficacy of metformin with chemotherapy or endocrine therapy in breast cancer patients according to the treatment setting, including neoadjuvant, adjuvant, and metastasis/recurrence. Methods We systematically searched for randomized controlled trials (RCTs) in MEDLINE, CENTRAL, and EMBASE from inception through July 2020. Overall survival (OS), progression-free survival (PFS), and hypoglycemia rate were the primary outcomes. Secondary outcomes included severe adverse events (SAEs) and relapse-free survival. We used the Grading of Recommendations Assessment, Development, and Evaluation approach and performed a meta-analysis to evaluate the efficacy and safety of metformin with chemotherapy and endocrine therapy in patients with breast cancer. Results Our systematic review included 412 participants from 5 trials. Metformin showed little to no difference in OS (hazard ratio [HR] = 1.13; 95% CI = 0.71-1.81; certainty of evidence [COE], moderate) and PFS (HR = 1.14; 95% CI = 0.86-1.50; COE, moderate) in patients with metastasis/recurrence. The evidence was very uncertain about the effect of metformin on survival outcomes in patients who received metformin with neoadjuvant or adjuvant treatment. Metformin showed little to no difference in hypoglycemia and SAEs. Conclusion and Relevance Metformin should be discouraged routinely in nondiabetic patients with metastatic/recurrent breast cancer. Further RCTs are needed to verify whether metformin with chemotherapy or endocrine therapy results in significant clinical benefits in the neoadjuvant or adjuvant setting. |
| Databáze: | OpenAIRE |
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