Efficacy of metformin therapy in patients with cancer: a meta-analysis of 22 randomised controlled trials

Autor: Jie Wen, Zhenjie Yi, Yuyao Chen, Jing Huang, Xueyi Mao, Liyang Zhang, Yu Zeng, Quan Cheng, Wenrui Ye, Zhixiong Liu, Fangkun Liu, Jingfang Liu
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Medicine, Vol 20, Iss 1, Pp 1-12 (2022)
Druh dokumentu: article
ISSN: 1741-7015
DOI: 10.1186/s12916-022-02599-4
Popis: Abstract Background To investigate whether metformin monotherapy or adjunctive therapy improves the prognosis in patients with any type of cancer compared to non-metformin users (age ≥18). Methods Databases (Medline, Embase, and the Cochrane Central Register of Controlled Trials) and clinical trial registries ( ClinicalTrials.gov ; the World Health Organization International Clinical Trials Registry Platform) were screened for randomized, controlled trials (RCT) reporting at least progression-free survival (PFS) and/or overall survival (OS). Main outcome measures included hazard ratios (HR), and combined HRs and 95% confidence intervals (CI) were calculated using random-effects models. Results Of the 8419 records screened, 22 RCTs comprising 5943 participants were included. Pooled HRs were not statistically significant in both PFS (HR 0.97, 95% CI 0.82–1.15, I 2 = 50%) and OS (HR 0.98, 95% CI 0.86–1.13, I 2 = 33%) for patients with cancer between the metformin and control groups. Subgroup analyses demonstrated that metformin treatment was associated with a marginally significant improvement in PFS in reproductive system cancers (HR 0.86, 95% CI 0.74–1.00) and a significantly worse PFS in digestive system cancers (HR 1.45, 95% CI 1.03–2.04). The PFS or OS was observed consistently across maintenance dose, diabetes exclusion, median follow-up, risk of bias, and combined antitumoral therapies. Conclusion Metformin treatment was not associated with cancer-related mortality in adults compared with placebo or no treatment. However, metformin implied beneficial effects in the PFS of the patients with reproductive system cancers but was related to a worse PFS in digestive system cancers. Systematic review registration PROSPERO registration number CRD42022324672.
Databáze: Directory of Open Access Journals
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