Metformin use and lung cancer survival: a population-based study in Norway
Open Access
- 2 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 124 (5), 1018-1025
- https://doi.org/10.1038/s41416-020-01186-9
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.Funding Information
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (88881.189827/2018-01)
This publication has 44 references indexed in Scilit:
- Synergistic effects of metformin in combination with EGFR-TKI in the treatment of patients with advanced non-small cell lung cancer and type 2 diabetesCancer Letters, 2015
- Effects of metformin on survival outcomes of lung cancer patients with type 2 diabetes mellitus: a meta-analysisClinical and Translational Oncology, 2015
- Comorbidity and Survival in Lung Cancer PatientsCancer Epidemiology, Biomarkers & Prevention, 2015
- Prognosis of small cell lung cancer patients with diabetes treated with metforminClinical and Translational Oncology, 2015
- Metformin use improves the survival of diabetic combined small-cell lung cancer patientsTumor Biology, 2015
- Survival of Patients with Stage IV Lung Cancer with Diabetes Treated with MetforminAmerican Journal of Respiratory and Critical Care Medicine, 2015
- Datakvaliteten i DødsårsaksregisteretTidsskrift for Den norske legeforening, 2015
- Reduced Risk of Lung Cancer With Metformin Therapy in Diabetic Patients: A Systematic Review and Meta-AnalysisAmerican Journal of Epidemiology, 2014
- Metformin and the Risk of CancerDiabetes Care, 2012
- Prognostic influence of metformin as first‐line chemotherapy for advanced nonsmall cell lung cancer in patients with type 2 diabetesCancer, 2011